Reset Residential

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

RESET RESIDENTIAL

Practice address

1137 Normandale Ave W
Petersburg, VA 23803-7921

Phone

(571) 830-9256

NPI assigned

Jan 4, 2025

Organization subpart

No

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

Authorized official

Name

Ja'Van Jefferson

Title

Managing/ Member

Phone

(571) 830-9256

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1735948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735948800000",
    "number": "1639988678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 NORMANDALE AVE W",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238037921",
            "telephone_number": "571-830-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1137 NORMANDALE AVE W",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238037921",
            "telephone_number": "571-830-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESET RESIDENTIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-04",
        "last_updated": "2025-01-04",
        "certification_date": "2025-01-03",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "JA'VAN",
        "authorized_official_title_or_position": "MANAGING/ MEMBER",
        "authorized_official_telephone_number": "571-830-9256"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2025; 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.