{"npi":"1154412492","type":"NPI-2","status":"active","name":{"display":"Evergreen Behavioral Health Center, Inc.","other":[],"organization_name":"EVERGREEN BEHAVIORAL HEALTH CENTER, INC.","authorised_official":"B. Fetty"},"specialty":{"primary_taxonomy":"251B00000X","primary_taxonomy_description":"Case Management Agency","slug":"case-management-agency","schema_org_specialty":null,"all":[{"code":"251B00000X","description":"Case Management Agency","primary":true,"state":"WV","license":"112"}]},"addresses":[{"purpose":"LOCATION","street_1":"240 NORTH ST","city":"NEW MARTINSVILLE","state":"WV","postal_code":"261551771","country_code":"US","phone":"3044554415","fax":"3044552501"},{"purpose":"MAILING","street_1":"240 NORTH ST","city":"NEW MARTINSVILLE","state":"WV","postal_code":"261551771","country_code":"US","phone":"3044554415","fax":"3044552501"}],"license":{"state":"WV","number":"112"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"0005321000","state":"WV","issuer":null},{"type_code":"05","label":"Medicaid","value":"0005321002","state":"WV","issuer":null},{"type_code":"05","label":"Medicaid","value":"0005321001","state":"WV","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-09-28","last_updated":"2020-08-22","_meta":{"source":"NPPES","snapshot_date":"2020-08-22","doc_url":"https://findmynpi.com/api"}}