EVERGREEN PRESBYTERIAN MINISTRIES OF EAST TN NPI 1508984972

NPI Information

  • NPI: 1508984972
  • Provider Name: EVERGREEN PRESBYTERIAN MINISTRIES OF EAST TN
  • Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
  • Entity Type: Organization
  • Other Name: EVERGREEN PRESBYTERIAN MINISTRIES, INC.
  • Address: 1304 WILSON RD
    SUITE 105
    KNOXVILLE, TN
    ZIP 37912
  • Phone: (865) 689-4022

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NPI Details

EVERGREEN PRESBYTERIAN MINISTRIES OF EAST TN is a community based residential treatment facility, intellectual and/or developmental disabilities in Knoxville, TN. 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 EAST TN NPI is 1508984972. The provider is registered as an organization entity type.
The provider Other Name Is Evergreen Presbyterian Ministries, Inc..

The provider's business location address is:

1304 WILSON RD
SUITE 105
KNOXVILLE, TN
ZIP 37912-693
Phone: (865) 689-4022
Fax: (865) 689-4054

The provider's authorized official is John R Taylor .
The authorized official title is President and has the following contact phone number (318) 742-8440.

The enumeration date for this NPI number is 3/26/2007 and was last updated on 8/22/2020.

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
1320900000XCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

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
100678MEDICAIDTENNESSEE

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: 3/30/2025

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