EVERGREEN COOPER LANE COMMUNITY HOME
NPI 1063558138
Intermediate Care Facility, Intellectual Disabilities in Texarkana, TX

Active since January 29, 2007
3312 COOPER LN, TEXARKANA, TX 75503(903) 831-4632 Get Directions Write a Review

NPPES record last updated: June 16, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Evergreen Cooper Lane Community Home NPPES

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

EVERGREEN COOPER LANE COMMUNITY HOME (NPI 1063558138) 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 John R Taylor, President, as its authorized official.

NPPES Registry Identity

NPI1063558138
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameEVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS, INC.
Location Address3312 COOPER LNTexarkana, TX 75503-0025
Mailing Address2101 Highway 80Haughton, LA 71037-9488 · (318) 949-5500
Organization SubpartNo
Authorized OfficialJohn R TaylorPresident · (318) 949-5500
Enumeration DateJanuary 29, 2007
Last NPPES UpdateJune 16, 2008
NPI 1063558138 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 · 115404
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
3312 COOPER LN, Texarkana, TX 75503

Other Names 1

Doing Business AsEvergreen Cooper Lane Community Home

Other Identifiers 1

Medicaid000362801TX

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 1063558138. It was assigned to this organization in the NPPES registry on January 29, 2007. The provider is doing business as Evergreen Cooper Lane Community Home.

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

Evergreen Presbyterian Ministries Of Texas, Inc. is located at 3312 Cooper Ln, Texarkana, TX 75503. The listed phone number is (903) 831-4632.

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 June 16, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.