Evergreen Wagner Community Home

LBN: Evergreen Presbyterian Ministries Of Texas, Inc.
Evergreen Wagner Community Home is an health care organization with primary practice located at 7905 Peregrine Trl , Arlington TX 76001-6137. 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 (817) 477-5600, or through Taylor, John R via phone (318) 949-5500.

Contact Information

Primary practice address
7905 Peregrine Trl Arlington TX 76001-6137
Phone: (817) 477-5600
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 117486 Texas

Profile Details

NPI number 1306984349
LBN Legal business name Evergreen Presbyterian Ministries Of Texas, Inc.
DBA Doing business as Evergreen Wagner Community Home
Authorized official Taylor, John R
Entity Organization
Organization subpart 1 No
Enumeration date Feb 2nd, 2007
Last updated Jun 17th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306984349 NPPES
Texas MEDICAID 001012498

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