Resilient Life Center, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

RESILIENT LIFE CENTER, LLC

Practice address

9513 Hull Street Rd Ste a
North Chesterfield, VA 23236-1495

Phone

(804) 317-5710

Fax

(804) 763-3453

NPI assigned

Nov 4, 2024

Organization subpart

No

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

Authorized official

Name

Jennifer Ann Kell, LSWNPI 1497869598

Title

Ceo

Phone

(804) 317-5710

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Ann Kell, LCSW

  • Clinical Social Worker
  • North Chesterfield, VA
  • NPI 1497869598
  Medicare reassignment NPD Authorized official
• Ashley Lauren Floyd, MSW

  • Clinical Social Worker
  • North Chesterfield, VA
  • NPI 1033943444
  NPD
• Melissa Marshall Harper, MSW

  • Social Worker
  • North Chesterfield, VA
  • NPI 1225720758
  NPD
• Tanya Jones, MSW

  • Clinical Social Worker
  • North Chesterfield, VA
  • NPI 1184372799
  NPD

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1407679020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4504",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231120010",
            "telephone_number": "804-317-5710",
            "fax_number": "804-763-3453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9513 HULL STREET RD STE A",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232361495",
            "telephone_number": "804-317-5710",
            "fax_number": "804-763-3453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENT LIFE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-03",
        "status": "A",
        "authorized_official_last_name": "KELL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-317-5710",
        "authorized_official_credential": "LSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Melissa Kathryn Mabel Reterstoff

• Community/Behavioral Health Agency in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Community/Behavioral Health Agency in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.