Reset Residential

NPI #1639988678 in Petersburg, Virginia

Provider Information

NPI Number: 1639988678
Entity Type: Organization
Organization Name: Reset Residential
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jan 4, 2025
Last Updated: Jan 4, 2025

Practice Location

Address: 1137 NORMANDALE AVE W
City: Petersburg
State: Virginia
ZIP Code: 23803-7921
Phone: (571) 830-9256

Authorized Official

Name: JA'VAN JEFFERSON
Title: MANAGING/ MEMBER
Phone: (571) 830-9256

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Mental Illness	320800000X
Psychiatric Residential Treatment Facility	323P00000X
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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