Organization
EVERGREEN BEHAVIORAL MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANIEL PISTONEM M.D. (MEDICAL DIRECTOR)
(910) 641-0600
Entity
Organization
Contact information
Practice address
220 WINTERGREEN DR, G & H, LUMBERTON, NC 28358-2376
(910) 738-9420
(910) 671-9414
Mailing address
220 WINTERGREEN DR # G&H, LUMBERTON, NC 28358-2376
(910) 738-9420
(910) 671-9414
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
A8422
NC
Other
Enumeration date
09/14/2011
Last updated
09/14/2011
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