OrganizationActive
Evergreen Presbyterian Ministries, Inc.
NPI 1336288802 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Bossier City, LA
Provider details
- NPI number
- 1336288802
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Douglas Ryland, Regional Vice President(318) 949-5500
- License
- PCA 4608 (LA)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense PCA 4608 (LA)
Residential Treatment Facilities
Practice location
3907 Shed Rd
Bossier City, LA 71111-5214
Phone: (318) 747-9855
Approximate (ZIP-level) locationGet directions
Mailing address
2101 Highway 80
Haughton, LA 71037-9488
Other names (DBA / former)
- Doing business as
- Nwla Pca Services
Registry dates
- Enumerated
- 2007-02-05
- Last updated
- 2025-05-27
- Certified
- 2025-05-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.