Organization
EVERGREEN BEHAVIORAL
Active
Parent organization
EVERGREEN BEHAVIORAL MANAGEMENT, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
EVERGREEN BEHAVIORAL MANAGEMENT, INC.
Authorized official
MS. GINGER G. GORE (OWNER)
(910) 641-0600
Entity
Organization
Contact information
Practice address
1409 PINCKNEY STREET, WHITEVILLE, NC 28472-2220
(910) 641-0600
(910) 641-0606
Mailing address
P.O. BOX 425, WHITEVILLE, NC 28472-2220
(910) 641-0600
(910) 641-0606
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408980
—
NC
05
—
8702201
—
NC
Enumeration date
02/13/2009
Last updated
08/30/2011
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