Provider Demographics
NPI:1992296701
Name:GREENBROOK TMS, ARLINGTON, LLC
Entity type:Organization
Organization Name:GREENBROOK TMS, ARLINGTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL CENTER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:CEFALU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-356-1568
Mailing Address - Street 1:8405 GREENSBORO DR STE 120
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-5106
Mailing Address - Country:US
Mailing Address - Phone:703-356-1568
Mailing Address - Fax:703-356-0661
Practice Address - Street 1:1005 N GLEBE RD STE 450
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22201-5931
Practice Address - Country:US
Practice Address - Phone:571-257-3630
Practice Address - Fax:703-356-0661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center