EVERGREEN PRESBYTERIAN MINISTRIES, INC. (NPI# 1336288802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336288802 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PRESBYTERIAN MINISTRIES, INC. |
| Other Organization Name | NWLA PCA SERVICES |
| Practice Address |
3907 Shed Rd Bossier City LA 71111-5214 |
| Mailing Address |
2101 Highway 80 Haughton LA 71037-9488 |
| Practice Telephone | 3187479855 |
| Mailing Telephone | 3189495500 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2008-06-12 |
| 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 | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | PCA 4608 | LA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1971812 | 05 |
| Other Name | Type Code |
|---|---|
| NWLA PCA Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720539299 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15212 Wadesboro Dr., Ponchatoula, LA 70454 | 2016-10-20 |
| 1770931503 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24345 Harvey Lavigne Road, Ponchatoula, LA 70454 | 2016-06-02 |
| 1265880488 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3622 Groom Road, Baker, LA 70714 | 2016-05-27 |
| 1679921860 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10599 Gatlin Road, Hammond, LA 70403 | 2016-05-27 |
| 1376991570 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15822 Demarco Lane, Hammond, LA 70403 | 2016-05-27 |
| 1700234903 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 42175 Billville Road, Hammond, LA 70403 | 2016-05-27 |
| 1518315738 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5636 Brownfield Road, Baton Rouge, LA 70808 | 2016-05-27 |
| 1306294731 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 21147 Highway 22, Ponchatoula, LA 70454-7941 | 2016-05-26 |
| 1316393531 | Evergreen Presbyterian Ministries, Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1538 Camellia Dr, Hammond, LA 70403-6228 | 2016-05-06 |
| 1881049211 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 103 East Pecan St., Ponchatoula, LA 70454 | 2016-05-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | EVERGREEN PRESBYTERIAN MINISTRIES, INC. | 2101 Hwy 80, Haughton, LA 71037-9488 |
| Street Address |
3907 SHED RD |
| City | BOSSIER CITY |
| State | LA |
| Zip Code | 71111-5214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922147222 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3907 Shed Rd, Bossier City, LA 71111-5214 | 2007-02-05 |
| 1104965409 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3907 Shed Rd, Bossier City, LA 71111-5214 | 2007-02-05 |
| 1932248325 | Evergreen Presbyterian Ministries, Inc. | Day Training, Developmentally Disabled Services | 3907 Shed Rd, Bossier City, LA 71111-5214 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669007951 | Tamara 'tammy' Larck | Counselor | 1525 Fullilove Drive, Shreveport, LA 71111 | 2020-03-06 |
| 1912538315 | Lagniappe Chiropractic | Chiropractor | 2400 Airline Drive, Bossier City, LA 71111 | 2020-02-04 |
| 1649817420 | Lifecare Medical Transportation, LLC. | Non-emergency Medical Transport (VAN) | 25 Duck Haven Pointe, Bossier City, LA 71111 | 2019-11-29 |
| 1770126344 | Bertresea White Evans | Nurse Practitioner | Coastal Urgernt Care, 5314 Airline Drive, Bossier City, LA 71111 | 2019-10-25 |
| 1861964058 | Erika Davis Reed | Counselor | 1515 Doctors Dr # 16, Bossier City, LA 71111 | 2018-12-28 |
| 1518436898 | Charlotte Mckay | Case Manager/Care Coordinator | 31330 Hwy 22, Ste 101, Bossier City, LA 71111 | 2018-11-16 |
| 1992271464 | Np2u, LLC | Nurse Practitioner | 2008 Airline Drive Suite 300 #194, Bossier City, LA 71111 | 2018-10-22 |
| 1114416542 | Lashaunda Autrey | Counselor | 410 Half Moon Lane, Bossier, LA 71111 | 2018-05-01 |
| 1750887196 | Shenya Williams-pennywell | Counselor | 1007 Gould Drive Bldg 2, Suite 1, Bossier City, LA 71111 | 2018-04-04 |
| 1336647304 | Patrick Vance | Physical Therapist | 5000 Benton Rd Ste 1, Bossier City, LA 71111 | 2018-01-24 |
| Find all providers in zip 71111 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922147222 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3907 Shed Rd, Bossier City, LA 71111-5214 | 2007-02-05 |
| 1902275043 | Arc of Acadiana, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5401 Shed Rd, Bossier City, LA 71111-5420 | 2015-09-18 |
| 1811366958 | Arc of Acadiana, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5401 Shed Rd, Bossier City, LA 71111-5420 | 2015-09-18 |
| 1720454200 | Arc of Acadiana, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5401 Shed Road, Bossier City, LA 71111 | 2015-08-19 |
| 1134479066 | Arc of Acadiana, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5401 Shed Rd, Bossier City, LA 71111-5420 | 2012-09-18 |
| 1730307133 | Northwest Supports and Services Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5401 Shed Rd, Bossier City, LA 71111-5420 | 2007-04-23 |
| 1558589952 | Northwest Supports and Services Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5401 Shed Rd, Bossier City, LA 71111-5420 | 2007-04-23 |
| 1467670869 | Northwest Supports and Services Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5401 Shed Rd, Bossier City, LA 71111-5420 | 2007-04-23 |
| 1912125311 | Northwest Supports and Services Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5401 Shed Rd, Bossier City, LA 71111-5420 | 2007-04-23 |
| 1104965409 | Evergreen Presbyterian Ministries, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3907 Shed Rd, Bossier City, LA 71111-5214 | 2007-02-05 |
| Find all providers in BOSSIER CITY | ||||
| City | BOSSIER CITY |
| Zip Code | 71111 |
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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.