EVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS INC. NPI 1811036031

NPI Information

NPI: 1811036031
Provider Name: EVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS, INC.

Doing Business As: EVERGREEN HCS - NCTX 1

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
10810 SANDEN DR
DALLAS, TX
ZIP 75238
Phone: (972) 386-4834
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EVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS, INC. is a community based residential treatment facility, intellectual and/or developmental disabilities in Dallas, TX. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. EVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS, INC. NPI is 1811036031. The provider is registered as an organization entity type.
The provider Is Doing Business As Evergreen Hcs - Nctx 1.

The provider's business location address is:

10810 SANDEN DR
DALLAS, TX
ZIP 75238-337
Phone: (972) 386-4834

The provider's authorized official is John R Taylor .
The authorized official title is President and has the following contact phone number (318) 949-5500.

The enumeration date for this NPI number is 2/5/2007 and was last updated on 6/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		001007659	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	001007659	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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