OrganizationActive
Center for Family Life Extension, Inc.
NPI 1053682724 · Emotionally Disturbed Childrens' Residential Treatment Facility · Jackson, MS
Provider details
- NPI number
- 1053682724
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Elmina Johnson, Owner(601) 259-5745
- License
- CYS-CFL-TGH-01 (MS)
Specialties & taxonomies
- Emotionally Disturbed Childrens' Residential Treatment FacilityPrimary322D00000XLicense CYS-CFL-TGH-01 (MS)
Residential Treatment Facilities
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility320900000XLicense CYS-CFL-TGH-01 (MS)
Residential Treatment Facilities
Profile Score
Detailed profile(80/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1980 Highway 80 W
Jackson, MS 39204-2303
Phone: (601) 259-5745
Fax: (601) 871-8223
Street-level locationGet directions
Mailing address
1980 Highway 80 W
Jackson, MS 39204-2303
Registry dates
- Enumerated
- 2012-01-26
- Last updated
- 2021-03-22
- Certified
- 2021-03-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.