Organization
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Active
Other names
NWLA PCA Services
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS RYLAND (REGIONAL VICE PRESIDENT)
(318) 949-5500
Entity
Organization
Contact information
Practice address
3907 SHED RD, BOSSIER CITY, LA 71111-5214
(318) 747-9855
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 4608
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1971812
—
LA
Enumeration date
02/05/2007
Last updated
05/27/2025
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