Penny Drive Community Home
LBN: Evergreen Presbyterian Ministries, Inc.
Penny Drive Community Home is an health care organization with primary practice located at 1805 Penny Dr , Vinton LA 70668-4905. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded is the primary health care specialty.
Evergreen Presbyterian Ministries, Inc. can be contacted via phone (318) 949-5500, or through Craft, Merlon K via phone (318) 949-5500.
Contact Information
Primary practice address
1805 Penny Dr
Vinton LA 70668-4905
Phone: (318) 949-5500
Fax: (318) 949-5555
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded | 315P00000X | ||
| Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 320900000X | 220378161 | Louisiana |
Profile Details
| NPI number | 1952653024 |
|---|---|
| LBN Legal business name | Evergreen Presbyterian Ministries, Inc. |
| DBA Doing business as | Penny Drive Community Home |
| Authorized official | Craft, Merlon K |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 12th, 2012 |
| Last updated | Sep 9th, 2022 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952653024 | NPPES |
| Louisiana | MEDICAID | 1715557 |
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