Family Life Foundation Incorporation

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

FAMILY LIFE FOUNDATION INCORPORATION

Practice address

11721 Reisterstown Rd
Reisterstown, MD 21136-3320

Phone

(443) 405-3744

Fax

(443) 405-3778

NPI assigned

Mar 23, 2018

Last updated

Feb 8, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

FAMILY LIFE FOUNDATIONAs reported in NPPES

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

Authorized official

Name

Elizabeth Owolabi

Title

Ceo

Phone

(443) 570-4860

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Family lIfe Foundation Inc Other name

Tax ID family

Family Life Foundation Incorporation2 organizations share this tax ID, including this one

Part of

Family Life Foundation Incorporation

Other organizations with this tax ID 1

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

• Family Life Foundation Incorporation

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Reisterstown, MD
  • NPI 1043917560
  NPD tax ID

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1316441223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11721 REISTERSTOWN RD",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211363320",
            "telephone_number": "443-405-3744",
            "fax_number": "443-405-3778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11721 REISTERSTOWN RD",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211363320",
            "telephone_number": "443-405-3744",
            "fax_number": "443-405-3778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 Phlox Cir",
            "address_purpose": "LOCATION",
            "city": "Owings Mills",
            "state": "MD",
            "postal_code": "211172019",
            "country_code": "US",
            "telephone_number": "443-870-3587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY LIFE FOUNDATION INCORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY LIFE FOUNDATION",
        "enumeration_date": "2018-03-23",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "OWOLABI",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-570-4860"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "5766138000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766138000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family lIfe Foundation Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Reisterstown, MD
• Providers in Reisterstown, MD by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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.