Organization
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Active
Other names
SELA Community Services SIL
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R TAYLOR (PRESIDENT)
(318) 949-5500
Entity
Organization
Contact information
Practice address
906 C M FAGAN DR, SUITE 6-A, HAMMOND, LA 70403-6056
(985) 543-6591
(985) 543-6638
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
9957
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9957
—
LA
Enumeration date
01/22/2009
Last updated
01/22/2009
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