Organization · Type 2 NPI
Evergreen Presbyterian Ministries, Inc.
Intellectual Disabilities Intermediate Care Facility · Lake Charles, LA
NPI number
1174678957
Active
Practice location
2300 Norben Dr
Lake Charles, LA 70601-9010
Mailing address
2101 Highway 80
Haughton, LA 71037-9488
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 644 (LA) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
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About NPI 1174678957
Evergreen Presbyterian Ministries, Inc.'s National Provider Identifier is 1174678957, issued on Jan 24, 2007. The primary taxonomy on file is Intellectual Disabilities Intermediate Care Facility (315P00000X), and the practice location is in Lake Charles, LA. The record was last updated on Jun 13, 2008.