Organization
EVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS, INC.
Active
Other names
Evergreen Meadow Lane Community Home
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R TAYLOR (PRESIDENT)
(318) 949-5500
Entity
Organization
Contact information
Practice address
20 MEADOW LN, TEXARKANA, TX 75503-2680
(903) 792-2529
Mailing address
2101 HIGHWAY 80, HAUGHTON, LA 71037-9488
(318) 949-5500
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
118995
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000363801
—
TX
Enumeration date
01/30/2007
Last updated
06/16/2008
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