NPIMap

Organization Active NPI

Evergreen Behavioral Management, Inc.

Doing business as Cardinal House

  • Assisted Living Facility
  • Wilmington, NC
National Provider Identifier
1457651309
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
EVERGREEN BEHAVIORAL MANAGEMENT, INC.
Doing business as
Cardinal House
Practice address
46 S Cardinal Dr
Wilmington, NC 28403-1843
Phone
(910) 641-0600
Fax
(910) 641-0606
NPI assigned
Oct 26, 2010
Last updated
Oct 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Ginger G. Gore
Title
Ceo/Owner
Phone
(910) 641-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

46 S Cardinal Dr
Wilmington, NC 28403-1843

Mailing address

1409 Pinckney St
Whiteville, NC 28472-2220
Phone (910) 641-0600

Other names 1

  • Cardinal House Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Management14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288051200000",
    "number": "1457651309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1409 PINCKNEY ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284722220",
            "telephone_number": "910-641-0600",
            "fax_number": "910-641-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 S CARDINAL DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284031843",
            "telephone_number": "910-641-0600",
            "fax_number": "910-641-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN BEHAVIORAL MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2010-10-26",
        "status": "A",
        "authorized_official_last_name": "GORE",
        "authorized_official_first_name": "GINGER",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "910-641-0600",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardinal House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.