MEDICARE: UTOPIA BEGINNINGS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1932954179
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UTOPIA BEGINNINGS, LLC

Provider Business Mailing Address
First Line	:	2519 LYNN AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-1925
Country	:	US
Telephone Number	:	937-867-9329
Fax Number	:

Provider Business Practice Location Address
First Line	:	2519 LYNN AVE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45406-1925
Country	:	US
Telephone Number	:	937-867-9329
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MR. GEORGE ANDERSON III
Credential	:
Telephone Number	:	937-867-9329

Provider Enumeration Date	:	04/22/2024
Last Update Date	:	04/22/2024

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Directions to “UTOPIA BEGINNINGS, LLC ” Practice Location

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