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Organization
VIA COGNITIVE HEALTH, INC.
Active
Organization
VIA COGNITIVE HEALTH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PENNINGTON (EXECUTIVE DIRECTOR)
(706) 738-5039
Entity
Organization
Contact information
Practice address
1901 CENTRAL AVE, AUGUSTA, GA 30904
(706) 738-5039
(706) 364-1288
Mailing address
1901 CENTRAL AVE, AUGUSTA, GA 30904-4125
(906) 738-5039
(706) 364-1288
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
NULL
302F00000X
Exclusive Provider Organization
Primary
121R0030
GA
Other
Enumeration date
08/31/2016
Last updated
03/06/2023
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