Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Center for Family Life Extension, Inc

Organization Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1053682724

Center for Family Life Extension, Inc is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jackson, Mississippi. Licensed in Mississippi. Registered with an NPI since 2012.

Licensed in
MS
In the registry since
2012
Specialties on file
2
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

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

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emotionally Disturbed Childrens' Residential Treatment Facility (primary) Taxonomy 322D00000X · Licence CYS-CFL-TGH-01 (MS)
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Taxonomy 320900000X · Licence CYS-CFL-TGH-01 (MS)

Record details

NPI number1053682724
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Elmina Johnson — Owner · (601) 259-5745
NPI enumeratedJanuary 26, 2012
Last updated in NPPESMarch 22, 2021
Certification dateMarch 22, 2021
Mailing address1980 Highway 80 W, Jackson, MS 39204-2303

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