EVERGREEN DANVILLE ROAD COMMUNITY HOME
NPI 1043356009
Intermediate Care Facility, Intellectual Disabilities in Texarkana, TX

Q: What is Evergreen Presbyterian Ministries Of Texas, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

Active since January 29, 2007

1302 WOOD ST, TEXARKANA, TX 75501(903) 794-0517 Get Directions Write a Review

NPPES record last updated: December 13, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Evergreen Danville Road Community Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EVERGREEN DANVILLE ROAD COMMUNITY HOME (NPI 1043356009) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Texarkana, Texas and active in the NPI registry since January 2007. The organization lists Susan M Buchholtz, President, as its authorized official.

NPPES Registry Identity

NPI1043356009

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameEVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS, INC.

Location Address1302 WOOD STTexarkana, TX 75501-4472

Mailing Address2101 Highway 80Haughton, LA 71037-9488 · (318) 949-5500

Phone(903) 794-0517

Organization SubpartNo

Authorized OfficialSusan M BuchholtzPresident · (318) 949-5500

Enumeration DateJanuary 29, 2007

Last NPPES UpdateDecember 13, 2024

NPPES CertifiedDecember 13, 2024

✔ NPI 1043356009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities

Taxonomy Code315P00000X

License✔ Licensed in TX · 118062

Definition

An intermediate care facility providing services for individuals with intellectual disabilities.

1302 WOOD ST, Texarkana, TX 75501

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Other Names 1

Doing Business AsEvergreen Danville Road Community Home

Other Identifiers 1

Medicaid000722401TX

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Evergreen Presbyterian Ministries Of Texas, Inc.'s NPI number?

The NPI number for Evergreen Presbyterian Ministries Of Texas, Inc. is 1043356009. It was assigned to this organization in the NPPES registry on January 29, 2007. The provider is doing business as Evergreen Danville Road Community Home.

Where is Evergreen Presbyterian Ministries Of Texas, Inc. located?

Evergreen Presbyterian Ministries Of Texas, Inc. is located at 1302 Wood St, Texarkana, TX 75501. The listed phone number is (903) 794-0517.

What is Evergreen Presbyterian Ministries Of Texas, Inc.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Evergreen Presbyterian Ministries Of Texas, Inc. was last updated on December 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.