Organization
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Active
Other names
Amanda Rock Community Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN R TAYLOR (PRESIDENT)
(318) 949-5500
Entity
Organization
Contact information
Practice address
301 KNAPP ST, LEESVILLE, LA 71446-3035
(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
APPLIED FOR
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
APPLIED FOR
—
LA
Enumeration date
04/29/2010
Last updated
04/29/2010
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