Evergreen Presbyterian Ministries of Texas, Inc.

NPI #1073976171 in Texarkana, Texas

Provider Information

NPI Number: 1073976171
Entity Type: Organization
Organization Name: Evergreen Presbyterian Ministries of Texas, Inc.
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Apr 5, 2016
Last Updated: Apr 5, 2016

Practice Location

Address: 1319 MAGNOLIA ST
City: Texarkana
State: Texas
ZIP Code: 75501-4440
Phone: (903) 794-0517

Authorized Official

Name: MR. MERLON KENT CRAFT
Title: EXECUTIVE VICE PRESIDENT / CFO
Phone: (318) 949-5515

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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