Penny Drive Community Home

LBN: Evergreen Presbyterian Ministries, Inc.
Penny Drive Community Home is an health care organization with primary practice located at 1805 Penny Dr , Vinton LA 70668-4905. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded is the primary health care specialty. Evergreen Presbyterian Ministries, Inc. can be contacted via phone (318) 949-5500, or through Craft, Merlon K via phone (318) 949-5500.

Contact Information

Primary practice address
1805 Penny Dr Vinton LA 70668-4905
Phone: (318) 949-5500
Fax: (318) 949-5555
Website:
Map and Directions
Authorized official contact:
Name: Craft, Merlon K
Phone: (318) 949-5500

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X 220378161 Louisiana

Profile Details

NPI number 1952653024
LBN Legal business name Evergreen Presbyterian Ministries, Inc.
DBA Doing business as Penny Drive Community Home
Authorized official Craft, Merlon K
Entity Organization
Organization subpart 1 No
Enumeration date Oct 12th, 2012
Last updated Sep 9th, 2022 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952653024 NPPES
Louisiana MEDICAID 1715557

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