Organization
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MERLON K CRAFT (EXECUTIVE VICE PRESIDENT / CFO)
(318) 949-5500
Entity
Organization
Contact information
Practice address
1340 HORRIDGE ST, VINTON, LA 70668-4532
(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
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
6705
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1039161
—
LA
Enumeration date
01/18/2013
Last updated
01/18/2013
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