EVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS, INC. (NPI# 1063558138) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063558138 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS, INC. |
| Other Organization Name | EVERGREEN COOPER LANE COMMUNITY HOME |
| Practice Address |
3312 Cooper Ln Texarkana TX 75503-0025 |
| Mailing Address |
2101 Highway 80 Haughton LA 71037-9488 |
| Practice Telephone | 9038314632 |
| Mailing Telephone | 3189495500 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2008-06-16 |
| Authorized Official Name | JOHN R TAYLOR (PRESIDENT) |
| Authorized Official Telephone | 3189495500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 115404 | TX | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 000362801 | 05 |
| Other Name | Type Code |
|---|---|
| Evergreen Cooper Lane Community Home | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053450270 | Evergreen Presbyterian Ministries of Texas, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1319 Magnolia St, Texarkana, TX 75501-4440 | 2007-02-05 |
| 1023156726 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 225 Syble Ln, Longview, TX 75605-9251 | 2007-02-02 |
| 1306984349 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 7905 Peregrine Trl, Arlington, TX 76001-6137 | 2007-02-02 |
| 1417095712 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 329 Montana Dr, Arlington, TX 76002-4473 | 2007-02-01 |
| 1194863225 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 159 Carriage Estates Rd, Sherman, TX 75092-4421 | 2007-02-01 |
| 1669519617 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 911 Salida Dr, Arlington, TX 76001-6122 | 2007-01-31 |
| 1730226408 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 5322 Hidden Ct, Garland, TX 75043-4832 | 2007-01-31 |
| 1073650040 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 1732 Northbrook Ln, Sherman, TX 75092-6023 | 2007-01-31 |
| 1932246956 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 530 Pebblecreek Dr, Garland, TX 75040-3605 | 2007-01-31 |
| 1982741997 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 1901 Island View Dr, Mesquite, TX 75149-5425 | 2007-01-31 |
| Street Address |
3312 COOPER LN |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503-0025 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386036192 | New Horizons Legacy | Intermediate Care Facility, Mentally Retarded | 4939 Elizabeth St, Texarkana, TX 75503-2911 | 2015-03-03 |
| 1609912120 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 20 Meadow Ln, Texarkana, TX 75503-2680 | 2007-01-30 |
| 1336285857 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 3611 Moores Ln, Texarkana, TX 75503-2214 | 2007-01-30 |
| 1245376763 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 3002 Fortune Ave, Texarkana, TX 75503-1561 | 2007-01-30 |
| 1689710766 | Evergreen Presbyterian Ministries of Texas, Inc. | Intermediate Care Facility, Mentally Retarded | 106 Maryland Dr, Texarkana, TX 75501-9535 | 2007-01-29 |
| 1659424901 | Housing Opportunities Addition, Inc. | Intermediate Care Facility, Mentally Retarded | 4600 County Ave, Texarkana, AR 71854-1410 | 2007-01-19 |
| 1194890996 | Horizons General Partnership | Intermediate Care Facility, Mentally Retarded | 4904 Elizabeth St, Texarkana, TX 75503-2912 | 2006-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639271 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3323 Gail Ln, Tyler, TX 75701-7425 | 2020-11-05 |
| 1952902900 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2500 Terry Pl, Greenville, TX 75402-7131 | 2020-11-05 |
| 1811598865 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 100 Patti J St, Greenville, TX 75402-8053 | 2020-11-05 |
| 1124629175 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2616 Pounds Ave, Tyler, TX 75701-5627 | 2020-11-05 |
| 1568063527 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2525 Preston Ave, Tyler, TX 75701-4644 | 2020-11-05 |
| 1104427509 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 2812 Shaffer Ln, Tyler, TX 75702-1653 | 2020-11-03 |
| 1265033658 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3506 Garber Cir, Greenville, TX 75402-6234 | 2020-11-03 |
| 1487255873 | St. Giles Living Centers, Inc. | Intermediate Care Facility, Mentally Retarded | 3600 New Copeland Rd, Tyler, TX 75701-8839 | 2020-11-03 |
| 1306446000 | Daybreak, Inc. | Intermediate Care Facility, Mentally Retarded | 6520 Braddock Pl, Dallas, TX 75232-2902 | 2020-10-30 |
| 1578179750 | Keondra C Johnson | Intermediate Care Facility, Mentally Retarded | 2140 Medical District Dr Apt 2052, Dallas, TX 75235-8097 | 2020-09-22 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.