MEDICARE: UTOPIAN INSTITUTE OF FAMILY LIVING 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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1588221352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UTOPIAN INSTITUTE OF FAMILY LIVING LLC

Provider Business Mailing Address
First Line	:	6188 OXON HILL RD STE 401
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-3157
Country	:	US
Telephone Number	:	870-290-0201
Fax Number	:	240-838-3253

Provider Business Practice Location Address
First Line	:	6188 OXON HILL RD STE 401
Second Line	:
City	:	OXON HILL
State	:	MD
Zip	:	20745-3157
Country	:	US
Telephone Number	:	877-290-0201
Fax Number	:	240-838-3253

Authorized Official
Title or Position	:	HUMAN RESOURCE DIRECTOR
Name	:	TENNILLE HARRIS
Credential	:
Telephone Number	:	877-290-0201

Provider Enumeration Date	:	05/28/2019
Last Update Date	:	01/18/2022

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