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General NPI Number Information
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NPI Number | 1457053787
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Entity Type | Organization
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Legal Business Name | UTOPIAN INSTITUTE OF FAMILY LIVING LLC
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Dates
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Enumeration Date | 03/20/2023
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Last Update Date | 03/20/2023
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Provider Practice Location Address
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Address Line | 6188 OXON HILL RD STE 101
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City | OXON HILL
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State | MD
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Zip | 20745-3149
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Country | US
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Telephone | 240-493-7580
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Fax | 240-838-3253
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Provider Business Mailing Address
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Address Line | 6188 OXON HILL RD STE 401
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City | OXON HILL
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State | MD
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Zip | 20745-3157
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Country | US
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Telephone | 240-838-3094
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Fax | 240-838-3253
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. TENNILLE HARRIS
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Credential |
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Telephone | 877-290-0201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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