Brenton House

LBN: Evergreen Behavioral Management, Inc.
Brenton House is an health care organization with primary practice located at 5794 Old Highway 74 , Chadbourn NC 28431-6779. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children, which is considered as the primary health care specialty. Evergreen Behavioral Management, Inc. can be contacted via phone (910) 654-3591, or through Gore, Ginger Gayle via phone (910) 641-0600.

Contact Information

Primary practice address
5794 Old Highway 74 Chadbourn NC 28431-6779
Phone: (910) 654-3591
Fax: (910) 654-3591
Website:
Map and Directions
Authorized official contact:
Name: Gore, Ginger Gayle
Phone: (910) 641-0600

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Emotionally Disturbed Children 322D00000X MHL024074 North Carolina

Profile Details

NPI number 1588816789
LBN Legal business name Evergreen Behavioral Management, Inc.
DBA Doing business as Brenton House
Authorized official Gore, Ginger Gayle
Entity Organization
Organization subpart 1 Yes
Enumeration date Oct 21st, 2008
Last updated Oct 21st, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588816789 NPPES
North Carolina MEDICAID 6603239

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