EVERGREEN FORTUNE COMMUNITY HOME
NPI 1245376763
Intermediate Care Facility, Intellectual Disabilities in Texarkana, TX

Active since January 30, 2007
3002 FORTUNE AVE, TEXARKANA, TX 75503(903) 838-5625 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 Fortune Community Home NPPES

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

EVERGREEN FORTUNE COMMUNITY HOME (NPI 1245376763) 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

NPI1245376763
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameEVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS, INC.
Location Address3002 FORTUNE AVETexarkana, TX 75503-1561
Mailing Address2101 Highway 80Haughton, LA 71037-9488 · (318) 949-5500
Organization SubpartNo
Authorized OfficialJohn R TaylorPresident · (318) 949-5500
Enumeration DateJanuary 30, 2007
Last NPPES UpdateJune 16, 2008
NPI 1245376763 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 · 116558
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
3002 FORTUNE AVE, Texarkana, TX 75503

Other Names 1

Doing Business AsEvergreen Fortune Community Home

Other Identifiers 1

Medicaid000724801TX

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 1245376763. It was assigned to this organization in the NPPES registry on January 30, 2007. The provider is doing business as Evergreen Fortune Community Home.

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

Evergreen Presbyterian Ministries Of Texas, Inc. is located at 3002 Fortune Ave, Texarkana, TX 75503. The listed phone number is (903) 838-5625.

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.