EVERGREEN BEHAVIORAL MANAGEMENT, INC. (NPI# 1497994099) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497994099 |
| Entity Type | Organization |
| Organization Name | EVERGREEN BEHAVIORAL MANAGEMENT, INC. |
| Practice Address |
1911 S 17th St Suite 100 Wilmington NC 28401-6662 |
| Mailing Address |
Po Box 425 Whiteville NC 28472-0425 |
| Practice Telephone | 9107919625 |
| Practice Fax Number | 9107929799 |
| Mailing Telephone | 9106405512 |
| Mailing Fax Number | 9106410606 |
| Enumeration Date | 2009-02-05 |
| Last Update Date | 2009-03-13 |
| Authorized Official Name | MRS. GINGER G GORE (OWNER) |
| Authorized Official Telephone | 9106405512 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8300538 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174823413 | Evergreen Behavioral Management, Inc. | Assisted Living Facility | 5794 Old Us Highway 74, Chadbourn, NC 28431-6779 | 2010-11-02 |
| 1457651309 | Evergreen Behavioral Management, Inc. | Assisted Living Facility | 46 S Cardinal Dr, Wilmington, NC 28403-1843 | 2010-10-26 |
| 1679712277 | Evergreen Behavioral Management, Inc. | Community/Behavioral Health | 4276 Legend Ave Ste C, Fayetteville, NC 28303-3497 | 2009-02-05 |
| 1588816789 | Evergreen Behavioral Management, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 5794 Old Highway 74, Chadbourn, NC 28431-6779 | 2008-10-21 |
| 1538311972 | Evergreen Behavioral Management, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1686 Sam Potts Hwy, Hallsboro, NC 28442-9458 | 2008-10-16 |
| 1508167735 | Evergreen Behavioral Management, Inc. | Assisted Living Facility | 1686 Sam Potts Hwy, Hallsboro, NC 28442-9458 | 2010-11-04 |
| 1669780300 | Evergreen Behavioral Management, Inc. | Clinic/Center | 1409 Pinckney St, Whiteville, NC 28472-2220 | 2010-09-15 |
| 1609189745 | Evergreen Behavioral Management, Inc. | Technician | 416 Fairley St, Laurinburg, NC 28352-3612 | 2010-07-19 |
| 1225277353 | Evergreen Behavioral Management, Inc. | Community/Behavioral Health | 1409 Pinckney St, Whiteville, NC 28472-2220 | 2009-02-12 |
| 1528206174 | Evergreen Behavioral Management, Inc. | Community/Behavioral Health | 416 Fairley St, Laurinburg, NC 28352-3612 | 2009-02-04 |
| Street Address |
1911 S 17TH ST SUITE 100 |
| City | WILMINGTON |
| State | NC |
| Zip Code | 28401-6662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023010105 | Katie O Gilbert | Family Medicine | 1911 S 17th St, Wilmington, NC 28401-6662 | 2005-06-02 |
| 1588105001 | Atkins Family Practice Pa | Physician Assistant | 1911 S 17th St, Ste 130a, Wilmington, NC 28401-6662 | 2017-03-16 |
| 1235537630 | Tiara Tate | Counselor | 1911 S 17th St, Suite 100, Wilmington, NC 28401-6662 | 2014-12-17 |
| 1427321918 | Jacqueline M Cowell | Physician Assistant | 1911 S 17th St, Suite 130a, Wilmington, NC 28401-6663 | 2012-02-15 |
| 1326320334 | Amy Lynn Lesane | Counselor | 1911 S 17th St, Wilmington, NC 28401-6662 | 2011-09-15 |
| 1659547230 | Celeste M Cianciulli | Counselor | 1911 S 17th St, Wilmington, Wilmington, NC 28401-6662 | 2008-05-05 |
| 1033255252 | Wendy Yvonne Shropshire-atkins | Family Medicine | 1911 S 17th St, Suite 130a, Wilmington, NC 28401-6662 | 2007-01-29 |
| 1720131329 | Bruce M Chapman Dpm Pa | Podiatrist | 1911 S 17th St, Suite 130-b, Wilmington, NC 28401-6662 | 2007-01-19 |
| 1427101070 | Abrons Family Practice and Urgent Care, P.a. | Family Medicine | 1911 S 17th St, Suite 130-a, Wilmington, NC 28401-6662 | 2007-01-18 |
| 1952458820 | Deborah Rosalie Ross | Psychiatry & Neurology | 1911 S 17th St, Suite 100, Wilmington, NC 28401-6662 | 2007-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275002461 | Thrivetothrive, LLC | Physical Therapist | 1606 Physicians Drive, Inside Promina Health, Wilmington, NC 28401 | 2018-11-16 |
| 1841787454 | Kevin Christopher Panebianco | Family Medicine | 1911 S 17th St Ste 130a, Wilmington, NC 28401 | 2018-04-18 |
| 1518472588 | Michelle Bruin | Family Medicine | 415 S. 2nd Street, Wilmington, NC 28401 | 2017-12-12 |
| 1639617343 | Anna Farwell | Behavior Technician | 3904 Oleander Dr. Suite 102, Wilmington, NC 28401 | 2017-02-02 |
| 1588034144 | Dimitri Zivko Pitovski | Allergy & Immunology | 1099 Medical Center Dr Unit 100b, Wilmington, NC 28401 | 2015-09-25 |
| 1629457007 | Megan Havel | Counselor | 1512 E Lakeshore Drive, Wilmington, NC 28401 | 2015-05-19 |
| 1154709251 | Lance Hutchens | Dentist | 1611 Doctors Cir, Wilmington, NC 28401 | 2015-05-11 |
| 1609281161 | Diane Pittman Whitford | Counselor | 313 Walnut St., Wilmington, NC 28401 | 2014-06-24 |
| 1942550728 | Bryan Cole Chalk | Nurse Anesthetist, Certified Registered | 2131 S 17th Street, Wilmington, NC 28401 | 2012-09-19 |
| 1740566546 | Valerie Baars | Pharmacist | 2302 S 17th Street, Wilmington, NC 28401 | 2011-10-25 |
| Find all providers in zip 28401 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
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| 1679192926 | Wraparound Maryland, Inc | Community/Behavioral Health | 105 Rogers Rd Ste A, Wilmington, DE 19801-5619 | 2020-04-15 |
| 1457983165 | Alapocas Collaborative Care, LLC | Community/Behavioral Health | 1601 Concord Pike Ste 66-68, Wilmington, DE 19803-3612 | 2020-02-11 |
| 1477011211 | M&l Prodigy Healthcare Inc | Community/Behavioral Health | 1 Jewel Dr, Wilmington, MA 01887-3385 | 2019-03-11 |
| 1457824369 | Ella Stanley Therapeutic Services, Inc. | Community/Behavioral Health | 1000 N West St Ste 1294, Wilmington, DE 19801-1050 | 2019-01-03 |
| 1134608136 | Alliance Behavioral Health | Community/Behavioral Health | 24505 S Avalon Blvd Apt 12, Wilmington, CA 90744-1068 | 2018-08-09 |
| 1063999688 | Tlc Operations, Inc | Community/Behavioral Health | 28 Beauregard Dr, Wilmington, NC 28412-6702 | 2018-07-26 |
| 1245752765 | Janelle G. Evans LLC | Community/Behavioral Health | 27 Tamarack Ave, Wilmington, DE 19805-5049 | 2017-07-17 |
| 1538698980 | Triad Ministry Inc | Community/Behavioral Health | 1104 N. Adams Street, Wilmington, DE 19801 | 2017-06-08 |
| 1356881551 | Jay's House, Inc | Community/Behavioral Health | 25 N Pennewell Dr, Wilmington, DE 19809-3313 | 2017-03-07 |
| Find all providers in WILMINGTON | ||||
| City | WILMINGTON |
| Zip Code | 28401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.