Center for Family Life Extensions, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

M7862 Issued in MS

Legal business name

CENTER FOR FAMILY LIFE EXTENSIONS, INC.

Practice address

1980 Highway 80 W
Jackson, MS 39204-2303

Phone

(601) 259-5745

Fax

(601) 871-8223

NPI assigned

Dec 6, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miss Amanda Johnson, LMSW

Title

Executive Director

Phone

(016) 259-5745

Specialties & licenses 1

Addresses

Tax ID family

Center for Family Life Extension Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Center for Family Life Extension, Inc.

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Jackson, MS
  • NPI 1053682724
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1033454772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 HIGHWAY 80 W",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392042303",
            "telephone_number": "601-259-5745",
            "fax_number": "601-871-8223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 HIGHWAY 80 W",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392042303",
            "telephone_number": "601-259-5745",
            "fax_number": "601-871-8223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR FAMILY LIFE EXTENSIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-06",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "016-259-5745",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MS",
            "license": "M7862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Cedoz, DO
• Bonnie Melissa Cefalu, DVM
• Celestial Health Creations
• Center for Diabetes Foot Care
• Center for Family Life Extension, Inc.
• Center of Infectious Disease Excellence
• Centerwell Senior Primary Care Ms PC (CenterWell Senior Primary Care-Jackson East)
• Centerwell Senior Primary Care Ms PC (CenterWell Senior Primary Care-Jackson West)
• Central Jackson Family Medical Clinic
• Central Jackson Medical Clinic, Inc

• Community/Behavioral Health Agency in Jackson, MS
• Providers in Jackson, MS by specialty
• Community/Behavioral Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.