NPIMap

Organization Active NPI

Evergreen Behavioral Management, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Whiteville, NC
National Provider Identifier
1669780300
Registry record updated Sep 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
EVERGREEN BEHAVIORAL MANAGEMENT, INC.
Practice address
1409 Pinckney St
Whiteville, NC 28472-2220
Phone
(910) 640-5512
Fax
(910) 641-0606
NPI assigned
Sep 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 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
Phone
(910) 641-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

1409 Pinckney St
Whiteville, NC 28472-2220

Mailing address

1409 Pinckney St
Whiteville, NC 28472-2220
Phone (910) 640-5512

National Provider Directory

National Provider Directory
Tax ID family
Evergreen Behavioral Mana14 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": "1284508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284508800000",
    "number": "1669780300",
    "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": "910-640-5512",
            "fax_number": "910-641-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1409 PINCKNEY ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284722220",
            "telephone_number": "910-640-5512",
            "fax_number": "910-641-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN BEHAVIORAL MANAGEMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-15",
        "last_updated": "2010-09-15",
        "status": "A",
        "authorized_official_last_name": "GORE",
        "authorized_official_first_name": "GINGER",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "910-641-0600",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.