Organization
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERLON KENT CRAFT (EXECUTIVE VICE PRESIDENT / CFO)
(318) 949-5515
Entity
Organization
Contact information
Practice address
15212 WADESBORO DR., PONCHATOULA, LA 70454
(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
—
—
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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