Organization
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MERLON K CRAFT (CFO)
(318) 949-5500
Entity
Organization
Contact information
Practice address
1805 PENNY DR, VINTON, LA 70668-4905
(318) 949-5500
(318) 949-5555
Mailing address
2101 HIGHWAY 80, HAUGHTON, LA 71037-9488
(318) 949-5500
(318) 949-5555
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
2203781160
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2203781160
—
LA
Enumeration date
10/22/2012
Last updated
10/22/2012
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