| Evergreen Behavioral Management Of Georgia, Inc. | |
|
8657 Hospital Dr Suite 101 A Douglasville GA 30134-2298 | |
| (770) 949-3118 | |
| (770) 949-3228 |
| Full Name | Evergreen Behavioral Management Of Georgia, Inc. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 8657 Hospital Dr, Douglasville, Georgia |
| Authorized Official Name and Position | Ginger G Gore (CEO) |
| Authorized Official Contact | 9106410600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Behavioral Management Of Georgia, Inc. Po Box 425 Whiteville NC 28472-0425 Ph: (910) 641-0600 | Evergreen Behavioral Management Of Georgia, Inc. 8657 Hospital Dr Suite 101 A Douglasville GA 30134-2298 Ph: (770) 949-3118 |
| NPI Number | 1548468762 |
|---|---|
| Provider Enumeration Date | 07/10/2007 |
| Last Update Date | 07/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548468762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (Georgia) | Primary |
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