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Organization

FAMILY LIFE FOUNDATION INCORPORATION

Active
Parent organization
FAMILY LIFE FOUNDATION
Other names
Family lIfe Foundation Inc
Organization subpart
Yes

Provider details

NPI number
Legal business name
FAMILY LIFE FOUNDATION
Authorized official
ELIZABETH OWOLABI (CEO)
(443) 570-4860
Entity
Organization

Contact information

Practice address
11721 REISTERSTOWN RD, REISTERSTOWN, MD 21136-3320
(443) 405-3744
(443) 405-3778
Mailing address
11721 REISTERSTOWN RD, REISTERSTOWN, MD 21136-3320
(443) 405-3744
(443) 405-3778

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
103TF0000X
Family Psychologist
103TP2701X
Group Psychotherapy Psychologist
1041C0700X
Clinical Social Worker
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5766138000
NPI
MD
05
766138000
MD
Enumeration date
03/23/2018
Last updated
02/08/2023
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