EVERGREEN BEHAVIORAL MANAGEMENT, INC. (NPI# 1588816789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588816789 |
| Entity Type | Organization |
| Organization Name | EVERGREEN BEHAVIORAL MANAGEMENT, INC. |
| Other Organization Name | BRENTON HOUSE |
| Practice Address |
5794 Old Highway 74 Chadbourn NC 28431-6779 |
| Mailing Address |
Po Box 425 Whiteville NC 28472-0425 |
| Practice Telephone | 9106543591 |
| Practice Fax Number | 9106543591 |
| Mailing Telephone | 9106410600 |
| Mailing Fax Number | 9106410606 |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2008-10-21 |
| Authorized Official Name | MS. GINGER GAYLE GORE (CEO) |
| Authorized Official Telephone | 9106410600 |
| Is Organization Subpart | Y |
| Parent Organization Name | EVERGREEN BEHAVIORAL MANAGEMENT, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | MHL024074 | NC | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 6603239 | 05 |
| Other Name | Type Code |
|---|---|
| Brenton House | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1497994099 | Evergreen Behavioral Management, Inc. | Community/Behavioral Health | 1911 S 17th St, Suite 100, Wilmington, NC 28401-6662 | 2009-02-05 |
| 1528206174 | Evergreen Behavioral Management, Inc. | Community/Behavioral Health | 416 Fairley St, Laurinburg, NC 28352-3612 | 2009-02-04 |
| Street Address |
5794 OLD HIGHWAY 74 |
| City | CHADBOURN |
| State | NC |
| Zip Code | 28431-6779 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356719694 | Antonio Terrill Scott | Behavioral Analyst | 216 Walls Lane, Chadbourn, NC 28431 | 2015-09-03 |
| 1831261494 | Suzette Marie Stines Dds Pllc | Dentist | 711 North Brown Street, Chadbourn, NC 28431 | 2006-11-15 |
| 1083128797 | Geeson, Rooks and Associates, Dds, Pa | Dentist | 711 N Brown St, Chadbourn, NC 28431 | 2017-11-17 |
| 1639321144 | Klondyke-chadbourn Volunteer Fire & Rescue Inc. | Ambulance | 204 N. Wilson, Chadbourn, NC 28431-0000 | 2008-10-15 |
| 1235276452 | Independent Medical Supplies Inc | Durable Medical Equipment & Medical Supplies | 633 N Brown St, Chadbourn, NC 28431-1305 | 2007-01-30 |
| 1265927719 | Allied Home Health Care, Inc | In Home Supportive Care | 636 N Brown St, Chadbourn, NC 28431-1306 | 2018-06-27 |
| 1467500736 | United Home Care Agency, Inc. | Home Health | 638 N Brown St, Chadbourn, NC 28431-1306 | 2007-01-05 |
| 1073972964 | James Clark & Associates, PC | Dentist | 711 N Brown St, Chadbourn, NC 28431-1307 | 2016-02-19 |
| 1417390618 | Kyle J Roth 5, Dds, Pa | Dentist | 711 N Brown St, Chadbourn, NC 28431-1307 | 2013-04-08 |
| 1720198427 | Kerr Drug Inc | Pharmacy | 811 N Brown St, Chadbourn, NC 28431-1309 | 2006-08-30 |
| Find all providers in zip 28431 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942404637 | Coming Together Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 5112 Chadbourn Hwy, Chadbourn, NC 28463 | 2007-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617255 | Creative Helping Hands LLC | Residential Treatment Facility, Emotionally Disturbed Children | 478 Green Lake Rd, Rockingham, NC 28379-7850 | 2020-10-19 |
| 1083237986 | Revive Housing LLC | Residential Treatment Facility, Emotionally Disturbed Children | 210 Sunset Dr Apt 615, Salisbury, NC 28147-7147 | 2020-05-26 |
| 1457998627 | Re Health Group | Residential Treatment Facility, Emotionally Disturbed Children | 1102 Groves St, Kings Mountain, NC 28086-2232 | 2019-12-05 |
| 1821631532 | Marquita Latrice Walls | Residential Treatment Facility, Emotionally Disturbed Children | 1565 Longbranch Rd, Grover, NC 28073-9599 | 2019-10-25 |
| 1699233866 | A Brighter Path LLC | Residential Treatment Facility, Emotionally Disturbed Children | 120 Jetter Rd, Grover, NC 28073-9687 | 2019-03-06 |
| 1821562224 | Carter Clinic, Pa | Residential Treatment Facility, Emotionally Disturbed Children | 703 W 3rd Ave Bldg A, Red Springs, NC 28377-1524 | 2019-01-18 |
| 1659842607 | Gervonia Robinson | Residential Treatment Facility, Emotionally Disturbed Children | 1714 Aster Ln, Gastonia, NC 28054-8303 | 2018-12-16 |
| 1679058440 | Miracle Houses Inc | Residential Treatment Facility, Emotionally Disturbed Children | 7827 Kerrybrook Cir, Charlotte, NC 28214-2513 | 2018-09-27 |
| 1174048078 | A Safe Place Community Housing, LLC | Residential Treatment Facility, Emotionally Disturbed Children | 2049 Highland St, Charlotte, NC 28208-4909 | 2017-08-11 |
| 1104346881 | Inspiration for Us | Residential Treatment Facility, Emotionally Disturbed Children | 1205 W Mountain St, Kernersville, NC 27284-2173 | 2017-06-22 |
| Find all providers with the same taxonomy | ||||
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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.