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Organization
EVERGREEN BEHAVIORAL MANAGEMENT INC
Active
Organization
EVERGREEN BEHAVIORAL MANAGEMENT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINGER G. GORE CEO OWNER OF COMPANY (CEO)
(910) 641-0600
Entity
Organization
Contact information
Practice address
1409 PINCKNEY ST, WHITEVILLE, NC 28472-2220
(910) 641-0600
(910) 641-0606
Mailing address
PO BOX 425, WHITEVILLE, NC 28472-0425
(910) 641-0600
(910) 641-0606
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6005966
—
NC
05
—
89015VM
—
NC
Enumeration date
10/26/2006
Last updated
05/16/2013
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