Provider Demographics
NPI:1104051747
Name:COGNITIVE CENTERS OF AMERICA, LLC
Entity type:Organization
Organization Name:COGNITIVE CENTERS OF AMERICA, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:H
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:205-283-1688
Mailing Address - Street 1:9340 HELENA RD
Mailing Address - Street 2:SUITE F-414
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1794
Mailing Address - Country:US
Mailing Address - Phone:205-641-2975
Mailing Address - Fax:888-773-3586
Practice Address - Street 1:631 BEACON PKWY W
Practice Address - Street 2:SUITE 203
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-3124
Practice Address - Country:US
Practice Address - Phone:205-641-2975
Practice Address - Fax:888-773-3586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-27
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty