# COGNIVIA CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053105411
- **Authorized official:** KERISHA S PRINCE PMHNP (OWNER)
- **Authorized official phone:** (718) 201-9840

## Contact information

- **Practice address:** 903 MAIN ST, MANCHESTER, CT 06040-6008
- **Practice address phone:** (860) 854-4733
- **Mailing address:** 903 MAIN ST, MANCHESTER, CT 06040-6008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/08/2025
- **Last updated:** 05/30/2025