Evergreen Stone Trail Community Home
LBN: Evergreen Presbyterian Ministries Of Texas, Inc.
Evergreen Stone Trail Community Home is an health care organization with primary practice located at 1205 Stone Trail St , Longview TX 75604-3533. 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 Of Texas, Inc. can be contacted via phone (903) 693-8221, or through Taylor, John R via phone (318) 949-5500.
Contact Information
Primary practice address
1205 Stone Trail St
Longview TX 75604-3533
Phone: (903) 693-8221
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded | 315P00000X | 115892 | Texas |
Profile Details
| NPI number | 1174669121 |
|---|---|
| LBN Legal business name | Evergreen Presbyterian Ministries Of Texas, Inc. |
| DBA Doing business as | Evergreen Stone Trail Community Home |
| Authorized official | Taylor, John R |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 29th, 2007 |
| Last updated | Jul 15th, 2009 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174669121 | NPPES |
| Texas | MEDICAID | 000735901 |
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