Provider Demographics
NPI:1427780360
Name:FAMILY LIFE FOUNDATION, INC.
Entity type:Organization
Organization Name:FAMILY LIFE FOUNDATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSYE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARSTOW
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:530-893-4245
Mailing Address - Street 1:130 YELLOWSTONE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-5884
Mailing Address - Country:US
Mailing Address - Phone:530-893-4245
Mailing Address - Fax:
Practice Address - Street 1:130 YELLOWSTONE DR STE 110
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-5884
Practice Address - Country:US
Practice Address - Phone:530-893-4245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty