CENTER FOR FAMILY LIFE EXTENSION INC. NPI 1053682724

NPI Information

CENTER FOR FAMILY LIFE EXTENSION, INC. is a residential treatment facility emotionally disturbed children in Jackson, MS. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. CENTER FOR FAMILY LIFE EXTENSION, INC. NPI is 1053682724. The provider is registered as an organization entity type.

The provider's business location address is:

1980 HIGHWAY 80 W
JACKSON, MS
ZIP 39204-303
Phone: (601) 259-5745
Fax: (601) 871-8223

The provider's authorized official is Elmina Johnson .
The authorized official title is Owner and has the following contact phone number (601) 259-5745.

The enumeration date for this NPI number is 1/26/2012 and was last updated on 3/22/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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