Provider Demographics
NPI:1558730432
Name:COGNITIVE TRAINING CENTERS OF VIRGINIA
Entity Type:Organization
Organization Name:COGNITIVE TRAINING CENTERS OF VIRGINIA
Other - Org Name:LEARNINGRX CHARLOTTESVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:DARGAN
Authorized Official - Last Name:COGGESHALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:BA, MBA
Authorized Official - Phone:434-220-7475
Mailing Address - Street 1:1441 SACHEM PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-2555
Mailing Address - Country:US
Mailing Address - Phone:434-220-7475
Mailing Address - Fax:540-962-9097
Practice Address - Street 1:1441 SACHEM PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-2555
Practice Address - Country:US
Practice Address - Phone:434-220-7475
Practice Address - Fax:540-962-9097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Single Specialty