Organization
EVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS, INC.
Active
Other names
Evergreen HCS - NCTX 1
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN R TAYLOR (PRESIDENT)
(318) 949-5500
Entity
Organization
Contact information
Practice address
10810 SANDEN DR, DALLAS, TX 75238-1337
(972) 386-4834
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
001007659
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001007659
—
TX
Enumeration date
02/05/2007
Last updated
06/17/2008
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