# JUMPSTART, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JUMPSTART, LLC
- **Other names:** JumpStart Autism Screening and Evaluations
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1477386852
- **Legal business name:** JUMPSTART, LLC
- **Authorized official:** BRIAN LOPEZ PHD (MANAGING MEMBER)
- **Authorized official phone:** (505) 828-3837

## Contact information

- **Practice address:** 8500 WASHINGTON ST NE STE A1, ALBUQUERQUE, NM 87113-1861
- **Practice address phone:** (505) 633-8500
- **Mailing address:** 8100 WYOMING BLVD NE M-4 ,\#406, ALBUQUERQUE, NM 87113
- **Mailing address phone:** (505) 828-3837
- **Mailing address fax:** (877) 828-1550

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | NULL | Yes |
| 103TC2200X | Clinical Child & Adolescent Psychologist | — | — | Yes |

## Other

- **Enumeration date:** 08/22/2024
- **Last updated:** 08/22/2024