Organization · Type 2 NPI

Evergreen Presbyterian Ministries of West TN

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Memphis, TN

NPI number 1063530442 Active

Practice location

5154 Stage Rd, Suite 100
Memphis, TN 38134-3118

Call (901) 381-9370 Map

Fax (901) 381-9368

Mailing address

2101 Highway 80
Haughton, LA 71037-9488

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

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About NPI 1063530442

Evergreen Presbyterian Ministries of West TN's National Provider Identifier is 1063530442, issued on Mar 26, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Memphis, TN. The record was last updated on Aug 22, 2020.