Organization
EVERGREEN OK ROOM & BOARD SUPPORT
Active
Other names
Evergreen Presbyterian Ministries, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R TAYLOR (PRESIDENT)
(318) 742-8440
Entity
Organization
Contact information
Practice address
7725 W BRITTON RD, OKLAHOMA CITY, OK 73132-1507
(405) 720-1192
(405) 720-1193
Mailing address
2101 HIGHWAY 80, HAUGHTON, LA 71037-9488
(318) 742-8440
(318) 752-5448
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/27/2007
Last updated
08/22/2020
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