| Organization Name: | COG RESTORE, LLC |
| NPI Number: | 1194108761 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RASHA A HARRIS (DIRECTOR OF OPERATIONS) |
| Mailing Address: | 9053 Estate Thomas Royal Palm Professional Building, Ste 206 St Thomas |
| State: | VI US |
| Postal Code: | 00802 |
| Phone Number: | 3407799355 |
| Fax Number: | |
| NPI Enumeration Date: | 07/01/2015 |
| NPI Last Update Date: | 07/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |