Foundation for Family Life

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

FOUNDATION FOR FAMILY LIFE

Practice address

11978 S Redwood Rd Ste C
Riverton, UT 84065-7403

Phone

(801) 750-5398

NPI assigned

May 9, 2019

Reactivated

Dec 20, 2019

Last updated

Dec 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Joseph White, PH.D.

Title

Executive Director

Phone

(801) 750-5398

Specialties & licenses 1

Addresses

Other names 1

• FLC Lab Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Family Life Center2 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.

• Foundation for Family Life

  dba Family Life Center

  • Professional Counselor
  • Riverton, UT
  • NPI 1912371378
  NPD tax ID

Locations

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576800000000",
    "number": "1205491735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1878 W 12600 S # 230",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657026",
            "telephone_number": "801-750-5398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11978 S REDWOOD RD STE C",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657403",
            "telephone_number": "801-750-5398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNDATION FOR FAMILY LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "deactivation_date": "2019-10-24",
        "reactivation_date": "2019-12-20",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-750-5398",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FLC Lab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Amber Lynne Ford
• Daniel Christopher Ford
• Jeramiah Fortune, DPT
• Forty-Five Degrees, P.C.
• Foundation for Family Life (FLC RR)
• Foundation for Family Life (Family Life Center)
• Matthew Fowlks
• Melinda Fowlks, LCSW
• Amber Frazier
• Madison Hope Frederick

• Clinical Medical Laboratory in Riverton, UT
• Providers in Riverton, UT by specialty
• Clinical Medical Laboratory in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.