Country Club Road Community Home

LBN: Evergreen Presbyterian Ministries, Inc.
Country Club Road Community Home is an health care organization with primary practice located at 98 Country Club Dr , Pineville LA 71360-2656. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Evergreen Presbyterian Ministries, Inc. can be contacted via phone (318) 640-4996, or through Taylor, John R via phone (318) 949-5500.

Contact Information

Primary practice address
98 Country Club Dr Pineville LA 71360-2656
Phone: (318) 640-4996
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Taylor, John R
Phone: (318) 949-5500

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 530 Louisiana

Profile Details

NPI number 1740334283
LBN Legal business name Evergreen Presbyterian Ministries, Inc.
DBA Doing business as Country Club Road Community Home
Authorized official Taylor, John R
Entity Organization
Organization subpart 1 No
Enumeration date Jan 22nd, 2007
Last updated Jun 12th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1740334283 NPPES
Louisiana MEDICAID 1717860

Popular Providers