Jumpstart Residential Services Inc

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

JUMPSTART RESIDENTIAL SERVICES INC

Practice address

1618 Kirkgate LN
Midlothian, VA 23114-3248

Phone

(804) 368-5640

Fax

(804) 895-7914

NPI assigned

Feb 2, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Robin Renee Russell, LPC

Title

Owner

Phone

(804) 368-5640

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1093411928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 KIRKGATE LN",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231143248",
            "telephone_number": "804-368-5640",
            "fax_number": "804-895-7914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 KIRKGATE LN",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231143248",
            "telephone_number": "804-368-5640",
            "fax_number": "804-895-7914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUMPSTART RESIDENTIAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "804-368-5640",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Jagdeep Kaur Kahlon, M.D.
• Anjali N Kalore, MD

• Substance Abuse Rehabilitation Facility in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Substance Abuse Rehabilitation Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.