Healthcare Provider Details

I. General information

NPI: 1801348834
Provider Name (Legal Business Name): A COGNITIVE CONNECTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2016
Last Update Date: 03/07/2022
Certification Date: 03/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 N ACADEMY BLVD # 385
COLORADO SPRINGS CO
80909-1567
US

IV. Provider business mailing address

2020 N ACADEMY BLVD # 385
COLORADO SPRINGS CO
80909-1567
US

V. Phone/Fax

Practice location:
  • Phone: 719-233-1199
  • Fax: 719-888-2216
Mailing address:
  • Phone: 719-233-1199
  • Fax: 719-888-2216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: CAROL LYNN VANNESS
Title or Position: OWNER
Credential:
Phone: 719-233-1199