Evergreen Presbyterian Ministries Of West Tn

NPI 1063530442 - Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities - 320900000X

NPI Details
NPI 1063530442
Enumeration Date 03/26/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JOHN R JOHN
Position PRESIDENT
Phone (901) 381-9370
Fax (901) 381-9368
Practice Location
5154 STAGE RD
SUITE 100
MEMPHIS TN, 38134-3118, US
Phone (901) 381-9370
Fax (901) 381-9368
Business Location
2101 HIGHWAY 80
HAUGHTON LA, 71037-9488, US
Phone (318) 742-8440
Fax (318) 752-5448
Toxanomy
Taxonomy Code 320900000X
License State
License Number
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According to our database, Evergreen Presbyterian Ministries Of West Tn NPI is 1063530442, taxonomy code is 320900000X Evergreen Presbyterian Ministries Of West Tn physically located at 5154 Stage Rd, Memphis TN, 38134-3118. NPI Number 1033115704 has the healthcare provider type.

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1063530442 NPI number is provided on an as is basis without warranty of any kind. 1063530442 is maintained by the National Plan & Provider Enumeration System. The contents of Evergreen Presbyterian Ministries Of West Tn are for informational purposes only.