EVERGREEN SUPPORTED EMPLOYMENT-CLA
NPI 1508910811
Day Training, Developmentally Disabled Services in Pineville, LA
- Organization
- Day Training, Developmentally Disabled S...
- CLIA Number: 19D1040696
- CLIA Cert. Type: Intermediate Care Facility for Mentally Retarded
- CLIA Exp. Date: 05-15-2027
About EVERGREEN SUPPORTED EMPLOYMENT-CLA
This page provides the complete NPI Profile along with additional information for Evergreen Supported Employment-cla, a provider established in Pineville, Louisiana operating as a Day Training, Developmentally Disabled Services. The healthcare provider is registered in the NPI registry with number 1508910811 assigned on January 2007. The practitioner's primary taxonomy code is 251C00000X with license number ADC 2403 (LA). The provider is registered as an organization and their NPI record was last updated 18 years ago. The provider's is doing business as Evergreen Supported Employment-cla. The authorized official of this NPI record is John R Taylor (President)
- NPI
- 1508910811 Verify this NPI
- Provider Legal Name
- EVERGREEN PRESBYTERIAN MINISTRIES, INC.
- Other Organization Name
- EVERGREEN SUPPORTED EMPLOYMENT-CLA
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 920 MAIN ST PINEVILLE, LA 71360
- Location Phone
- (318) 445-4470
- Mailing Address
- 2101 HIGHWAY 80 HAUGHTON, LA 71037
- Mailing Phone
- (318) 949-5500
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-23-2007
- Last Update Date
- 06-12-2008
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Day Training, Developmentally Disabled Services
- Taxonomy Code
- 251C00000X
- Type
- Agencies
- License No.
- ADC 2403
- License State
- LA
- Taxonomy Description
- These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1910368 | MEDICAID (05) | LA |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 19D1040696
- Facility Type
- Intermediate Care Facility for Mentally Retarded
- Certificate Effective Date
- May 16, 2025
- Certificate Expiration Date
- May 15, 2027
- Laboratory Director
- KATHY R. BLACKMAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Evergreen Supported Employment-cla to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
PINEVILLE, LA 71360
PINEVILLE, LA 71360
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1508910811, enumerated as an "organization" on January 23, 2007.
The provider is located at 920 MAIN ST PINEVILLE, LA 71360 and the phone number is (318) 445-4470.
Day Training, Developmentally Disabled Services with taxonomy code 251C00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
