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EVERGREEN SUPPORTED LIVING PROGRAM-CLA
NPI 1194879569
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Pineville, LA

Active since January 23, 2007CLIA 19D1040696 · Waiver
920 MAIN ST, PINEVILLE, LA 71360(318) 445-4470 Get Directions Write a Review

NPPES record last updated: June 12, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Evergreen Supported Living Program-cla NPPES

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

EVERGREEN SUPPORTED LIVING PROGRAM-CLA (NPI 1194879569) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Pineville, Louisiana and active in the NPI registry since January 2007. The organization holds a CLIA Waiver certificate valid through May 15, 2027 and lists John R Taylor, President, as its authorized official.

NPPES Registry Identity

NPI1194879569
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameEVERGREEN PRESBYTERIAN MINISTRIES, INC.
Location Address920 MAIN STPineville, LA 71360-6408
Mailing Address2101 Highway 80Haughton, LA 71037-9488 · (318) 949-5500
Phone(318) 445-4470
Organization SubpartNo
Authorized OfficialJohn R TaylorPresident · (318) 949-5500
Enumeration DateJanuary 23, 2007
Last NPPES UpdateJune 12, 2008
✔ NPI 1194879569 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
License✔ Licensed in LA · SIL 2447
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
920 MAIN ST, Pineville, LA 71360
Open in Google Maps ↗

Other Names 1

Doing Business AsEvergreen Supported Living Program-cla

Other Identifiers 1

Medicaid1910350LA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 19D1040696

Evergreen Presbyterian Ministries Inc Central La Division · Pineville, LA
Active · expires May 15, 2027
CLIA Number19D1040696
Laboratory TypeIntermediate Care Facility For Mentally Retarded
Certificate Effective DateMay 16, 2025
Certificate Expiration DateMay 15, 2027
Laboratory DirectorKathy R. Blackman
Laboratory Phone(318) 445-4470
Laboratory LocationEvergreen Presbyterian Ministries Inc Central La Division920 Main Street, Pineville, LA 71360
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Respite Care
920 MAIN ST
PINEVILLE, LA 71360
Rapides Parish (318) 445-4470
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
920 MAIN ST
PINEVILLE, LA 71360
Rapides Parish (318) 445-4470
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Day Training, Developmentally Disabled Services
920 MAIN ST
PINEVILLE, LA 71360
Rapides Parish (318) 445-4470

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, Inc.'s NPI number?

The NPI number for Evergreen Presbyterian Ministries, Inc. is 1194879569. It was assigned to this organization in the NPPES registry on January 23, 2007. The provider is doing business as Evergreen Supported Living Program-Cla.

Where is Evergreen Presbyterian Ministries, Inc. located?

Evergreen Presbyterian Ministries, Inc. is located at 920 Main St, Pineville, LA 71360. The listed phone number is (318) 445-4470.

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

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

Does Evergreen Presbyterian Ministries, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 19D1040696) is associated with this NPI, valid through May 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Evergreen Presbyterian Ministries, Inc. was last updated on June 12, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.