EVERGREEN STEVENS COMMUNITY HOME
NPI 1881730851
Intermediate Care Facility, Intellectual Disabilities in Kilgore, TX

Active since January 29, 2007
107 STEVEN ST, KILGORE, TX 75662(903) 643-7022 Get Directions Write a Review

NPPES record last updated: June 16, 2008. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Intermediate Care Facility, Intellectual...

About EVERGREEN STEVENS COMMUNITY HOME

This page provides the complete NPI Profile along with additional information for Evergreen Stevens Community Home, a provider established in Kilgore, Texas operating as a Intermediate Care Facility, Intellectual Disabilities. The healthcare provider is registered in the NPI registry with number 1881730851 assigned on January 2007. The practitioner's primary taxonomy code is 315P00000X with license number 115719 (TX). 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 Stevens Community Home. The authorized official of this NPI record is John R Taylor (President)

NPI
1881730851 Verify this NPI
Provider Legal Name
EVERGREEN PRESBYTERIAN MINISTRIES OF TEXAS, INC.
Other Organization Name
EVERGREEN STEVENS COMMUNITY HOME
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
107 STEVEN ST KILGORE, TX 75662
Location Phone
(903) 643-7022
Mailing Address
2101 HIGHWAY 80 HAUGHTON, LA 71037
Mailing Phone
(318) 949-5500
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-29-2007
Last Update Date
06-16-2008
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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

Intermediate Care Facility, Intellectual Disabilities

Taxonomy Code
315P00000X
Type
Nursing & Custodial Care Facilities
License No.
115719
License State
TX
Taxonomy Description
An intermediate care facility providing services for individuals with intellectual disabilities.

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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JOHN R TAYLOR

Authorized Official Title
PRESIDENT
Authorized Official Phone
(318) 949-5500

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
000757901MEDICAID (05)TX 

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1881730851, enumerated as an "organization" on January 29, 2007.

The provider is located at 107 STEVEN ST KILGORE, TX 75662 and the phone number is (903) 643-7022.

Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.