Provider Demographics
NPI:1366005712
Name:COGIC
Entity type:Organization
Organization Name:COGIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MINNIEWEATHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCCA
Authorized Official - Phone:713-631-0981
Mailing Address - Street 1:7809 WINSHIP ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77028-2441
Mailing Address - Country:US
Mailing Address - Phone:713-631-0981
Mailing Address - Fax:713-631-4713
Practice Address - Street 1:7809 WINSHIP ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77028-2441
Practice Address - Country:US
Practice Address - Phone:713-631-0981
Practice Address - Fax:713-631-4713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-20
Last Update Date:2019-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities