Organization · Type 2 NPI
Evergreen Presbyterian Ministries, Inc.
Intellectual Disabilities Intermediate Care Facility · Lake Charles, LA
NPI number
1437204385
Active
Practice location
505 Julius St
Lake Charles, LA 70605-2731
Mailing address
2101 Highway 80
Haughton, LA 71037-9488
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual Disabilities Intermediate Care Facility Primary | 315P00000X | 630 (LA) |
Intellectual Disabilities Intermediate Care Facility: An intermediate care facility providing services for individuals with intellectual disabilities.
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About NPI 1437204385
Evergreen Presbyterian Ministries, Inc.'s National Provider Identifier is 1437204385, issued on Jan 23, 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.