NPI 1053682724

Center for Family Life Extension, INC.

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Jackson, MS

Practice location

Address: 1980 Highway 80 W, Jackson, MS 39204-2303
Phone: (601) 259-5745
Fax: (601) 871-8223

Authorised official

Name: Elmina Johnson
Title: Owner
Phone: (601) 259-5745

Registered specialties (2)

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence CYS-CFL-TGH-01 (MS)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Mississippi →

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320900000X Licence CYS-CFL-TGH-01 (MS)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Mississippi →

Registry record

NPI: 1053682724
Entity type: Organization
NPI issued: 26 Jan 2012
Record last updated: 22 Mar 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.