Provider Demographics
NPI:1053515031
Name:EXTENDED FAMILY INC
Entity type:Organization
Organization Name:EXTENDED FAMILY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETSY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-568-0166
Mailing Address - Street 1:4228 GLENROY DR
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38125-3077
Mailing Address - Country:US
Mailing Address - Phone:901-568-0166
Mailing Address - Fax:901-755-9882
Practice Address - Street 1:4228 GLENROY DR
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38125-3077
Practice Address - Country:US
Practice Address - Phone:901-568-0166
Practice Address - Fax:901-755-9882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable