SECOND AVENUE COMMUNITY HOME
NPI 1215081302
Intermediate Care Facility, Intellectual Disabilities in Lake Charles, LA

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

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

Active since January 23, 2007

2410 2ND AVE, LAKE CHARLES, LA 70601(337) 497-1141 Get Directions Write a Review

NPPES record last updated: June 13, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Second Avenue Community Home NPPES

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

SECOND AVENUE COMMUNITY HOME (NPI 1215081302) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in Lake Charles, Louisiana and active in the NPI registry since January 2007. The organization lists John R Taylor, President, as its authorized official.

NPPES Registry Identity

NPI1215081302

Entity TypeOrganization

Primary Taxonomy315P00000X

Legal Business NameEVERGREEN PRESBYTERIAN MINISTRIES, INC.

Location Address2410 2ND AVELake Charles, LA 70601-7760

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

Phone(337) 497-1141

Organization SubpartNo

Authorized OfficialJohn R TaylorPresident · (318) 949-5500

Enumeration DateJanuary 23, 2007

Last NPPES UpdateJune 13, 2008

✔ NPI 1215081302 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 LA · 608

Definition

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

2410 2ND AVE, Lake Charles, LA 70601

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Other Names 1

Doing Business AsSecond Avenue Community Home

Other Identifiers 1

Medicaid1718602LA

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 1215081302. It was assigned to this organization in the NPPES registry on January 23, 2007. The provider is doing business as Second Avenue Community Home.

Where is Evergreen Presbyterian Ministries, Inc. located?

Evergreen Presbyterian Ministries, Inc. is located at 2410 2nd Ave, Lake Charles, LA 70601. The listed phone number is (337) 497-1141.

What is Evergreen Presbyterian Ministries, 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, Inc. was last updated on June 13, 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.