Organization

Evergreen Presbyterian Ministries, Inc.

May also be knows as Carroll Street Community Home

Intellectual Disabilities Intermediate Care Facility in Shreveport, LA(View on Map)

Legal Business Name

Evergreen Presbyterian Ministries, Inc.

Also Known As

Carroll Street Community Home

NPI Number

1457409153

NPI Type

Organization

Enumeration Date

01/08/2007

Specialties

(Taxonomies)

Code

315P00000X

Primary Taxonomy

Yes

Licenses

State

Louisiana

License Number

344

Contact
Information

Purpose

Mailing
Location

Address

2101 HIGHWAY 80
181 CARROLL ST

City

Haughton
Shreveport

State

LA
LA

Postal Code

71037-9488
71105-4234

Country

US
US

Telephone Number

(318) 949-5500
(318) 687-9622

Authorized Official

Name

John Taylor

Title or Position

PRESIDENT

Telephone Number

(318) 949-5500

Identifiers

Identifier

1715948

Identifier State

LA

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/12/2008

Provider Address

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