AMANDA ROCK COMMUNITY HOME – NPI #1457678591
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

AMANDA ROCK COMMUNITY HOME is a community based residential treatment facility located in LEESVILLE, LA. NPPES has assigned the NPI number 1457678591 to AMANDA ROCK COMMUNITY HOME on April 29, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “AMANDA ROCK COMMUNITY HOME” is a dba name, the actual legal business name for this organization is EVERGREEN PRESBYTERIAN MINISTRIES, INC.. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for AMANDA ROCK COMMUNITY HOME below.

NPI Profile for
EVERGREEN PRESBYTERIAN MINISTRIES, INC.

NPI Number
1457678591
Enumeration Date

(more than 16 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EVERGREEN PRESBYTERIAN MINISTRIES, INC.
Doing Business As (dba): AMANDA ROCK COMMUNITY HOME
Primary location
301 KNAPP ST
LEESVILLE, LA 71446-3035
Phone: (318) 949-5500 Fax: (318) 949-5555
Mailing address
2101 HIGHWAY 80
HAUGHTON, LA 71037-9488
Phone: (318) 949-5500 Fax: (318) 949-5555
Organization Subpart
No
Authorized Official
JOHN TAYLOR
PRESIDENT
Phone: (318) 949-5500
Updated
Identifiers

Identifiers for AMANDA ROCK COMMUNITY HOME

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDLAAPPLIED FOR
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)
LA APPLIED FOR

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.