Provider Demographics
NPI:1003174723
Name:UTOPIA FAMILY HOME, INC.
Entity Type:Organization
Organization Name:UTOPIA FAMILY HOME, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:POMARE-BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-394-7910
Mailing Address - Street 1:2706 MONTEGO DR
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33023-4623
Mailing Address - Country:US
Mailing Address - Phone:754-400-8230
Mailing Address - Fax:754-400-8233
Practice Address - Street 1:2706 MONTEGO DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-4623
Practice Address - Country:US
Practice Address - Phone:754-400-8230
Practice Address - Fax:754-400-8233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-01
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLALF12151310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108388Medicare PIN