Evergreen Arkansas Waiver Services

LBN: Evergreen Presbyterian Ministries Of Texas, Inc.
Evergreen Arkansas Waiver Services is an health care organization with primary practice located at 1319 Magnolia St , Texarkana TX 75501-4440. The organization recently has only one registered license in Agencies / Case Management, which is considered as the primary health care specialty. Evergreen Presbyterian Ministries Of Texas, Inc. can be contacted via phone (903) 794-0517, or through Taylor, John R via phone (318) 949-5500.

Contact Information

Primary practice address
1319 Magnolia St Texarkana TX 75501-4440
Phone: (903) 794-0517
Fax: (903) 792-1861
Website:
Map and Directions
Authorized official contact:
Name: Taylor, John R
Phone: (318) 949-5500

Health care specialties

SpecialtyCodeLicense #State
Agencies / Case Management 251B00000X

Profile Details

NPI number 1669668604
LBN Legal business name Evergreen Presbyterian Ministries Of Texas, Inc.
DBA Doing business as Evergreen Arkansas Waiver Services
Authorized official Taylor, John R
Entity Organization
Organization subpart 1 No
Enumeration date Sep 24th, 2007
Last updated Jun 16th, 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 1669668604 NPPES
Arkansas MEDICAID 129758774

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