Provider Demographics
NPI:1578249496
Name:COGNOSIS HEALTH
Entity Type:Organization
Organization Name:COGNOSIS HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:KURT
Authorized Official - Last Name:LIEGMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-428-1181
Mailing Address - Street 1:5445 ALI DR DEPT 320
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-5193
Mailing Address - Country:US
Mailing Address - Phone:810-428-1181
Mailing Address - Fax:810-426-0009
Practice Address - Street 1:5445 ALI DR DEPT 320
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-5193
Practice Address - Country:US
Practice Address - Phone:810-428-1181
Practice Address - Fax:810-426-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-26
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty