Organization
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Active
Other names
Evergreen Community Services-CLA PCA
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R TAYLOR (PRESIDENT)
(318) 949-5500
Entity
Organization
Contact information
Practice address
920 MAIN ST, PINEVILLE, LA 71360-6408
(318) 445-4470
Mailing address
2101 HIGHWAY 80, HAUGHTON, LA 71037-9488
(318) 949-5500
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
PCA 2623
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1957054
—
LA
Enumeration date
01/23/2007
Last updated
06/12/2008
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