MEDICARE: EVERGREEN PRESBYTERIAN MINISTRIES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility	503	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972657401
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EVERGREEN PRESBYTERIAN MINISTRIES, INC.

Provider Business Mailing Address
First Line	:	2101 HIGHWAY 80
Second Line	:
City	:	HAUGHTON
State	:	LA
Zip	:	71037-9488
Country	:	US
Telephone Number	:	318-949-5500
Fax Number	:

Provider Business Practice Location Address
First Line	:	8203 RIDGEMONT DR
Second Line	:
City	:	PINEVILLE
State	:	LA
Zip	:	71360-2651
Country	:	US
Telephone Number	:	318-640-2388
Fax Number	:

Authorized Official
Title or Position	:	REGIONAL VICE PRESIDENT
Name	:	DOUGLAS RYLAND
Credential	:
Telephone Number	:	318-949-5500

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	05/30/2025

Similar Medicare Providers

1457209819 — RAEGAN CARROL BROCATO
Practice Location Address:

1710 OAKLAND ST
PINEVILLE, LA
71360-5174

Practice Phone: 318-201-9396
Practice Fax:

1316892862 — MRS. BRIANNA SHAMBLIN
Practice Location Address:

156 JOY LN
PINEVILLE, LA
71360-2894

Practice Phone: 318-308-8717
Practice Fax:

1174478101 — CENLACARE LLC
Practice Location Address:

5101 HIGHWAY 28 EAST
PINEVILLE, LA
71360-4738

Practice Phone: 318-542-4441
Practice Fax: 318-542-4431

1306707757 — THE SOL HAUS
Practice Location Address:

4 LOFTON CEMETARY RD APT A
PINEVILLE, LA
71360-9765

Practice Phone: 504-994-3153
Practice Fax:

1053314187 — DR. MANU BHARGAVA M.D., F.A.A.P.
Practice Location Address:

101 MEDICAL PARK BLVD. , SUITE A
PINEVILLE, LA
71360

Practice Phone: 318-561-0252
Practice Fax: 318-561-2454

1801890751 — DR. RAYLAND KEVIN BEURLOT M.D.
Practice Location Address:

2495 SHREVEPORT HWY
PINEVILLE, LA
71360-4044

Practice Phone: 184-730-0103
Practice Fax: 318-445-3510

Directions to “EVERGREEN PRESBYTERIAN MINISTRIES, INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.