# VIA COGNITIVE HEALTH, INC.

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

## Provider details

- **NPI number:** 1972059780
- **Authorized official:** JENNIFER PENNINGTON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (706) 738-5039

## Contact information

- **Practice address:** 1901 CENTRAL AVE, AUGUSTA, GA 30904
- **Practice address phone:** (706) 738-5039
- **Practice address fax:** (706) 364-1288
- **Mailing address:** 1901 CENTRAL AVE, AUGUSTA, GA 30904-4125
- **Mailing address phone:** (906) 738-5039
- **Mailing address fax:** (706) 364-1288

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA0600X | Adult Day Care Clinic/Center | — | NULL | — |
| 302F00000X | Exclusive Provider Organization | 121R0030 | GA | Yes |

## Other

- **Enumeration date:** 08/31/2016
- **Last updated:** 03/06/2023