| Evergreen Behavioral Management, Inc. | |
|
416 Fairley St Laurinburg NC 28352-3612 | |
| (910) 276-8545 | |
| Not Available |
| Full Name | Evergreen Behavioral Management, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 416 Fairley St, Laurinburg, North Carolina |
| Authorized Official Name and Position | Ginger G Gore (OWNER) |
| Authorized Official Contact | 9106405512 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Behavioral Management, Inc. Po Box 425 Whiteville NC 28472-0425 Ph: (910) 640-5512 | Evergreen Behavioral Management, Inc. 416 Fairley St Laurinburg NC 28352-3612 Ph: (910) 276-8545 |
| NPI Number | 1528206174 |
|---|---|
| Provider Enumeration Date | 02/04/2009 |
| Last Update Date | 03/31/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528206174 | NPI | - | NPPES |
| 8302543 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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