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General NPI Number Information
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NPI Number | 1356859490
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Entity Type | Organization
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Legal Business Name | GREENBROOK TMS DURHAM LLC
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 01/17/2022
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Provider Practice Location Address
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Address Line | 1638 MEMORIAL DR
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City | BURLINGTON
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State | NC
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Zip | 27215-3518
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Country | US
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Telephone | 855-910-4867
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Fax |
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Provider Business Mailing Address
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Address Line | 890 YONGE STREET 7TH FLOOR
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City | TORONTO
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State | ON
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Zip | M4W3P4
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Country | CA
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM LEONARD
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Credential |
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Telephone | 416-915-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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