Provider Demographics
NPI:1750631974
Name:JUMP START WELLNESS
Entity Type:Organization
Organization Name:JUMP START WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZRENY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-225-4182
Mailing Address - Street 1:63 GRAHAM ROAD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223
Mailing Address - Country:US
Mailing Address - Phone:330-752-4370
Mailing Address - Fax:
Practice Address - Street 1:63 GRAHAM RD
Practice Address - Street 2:SUITE 2
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-1204
Practice Address - Country:US
Practice Address - Phone:330-752-4370
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ABILIKIDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2691243Medicaid