Provider Demographics
NPI:1477971620
Name:UTOPIA COMPANION
Entity Type:Organization
Organization Name:UTOPIA COMPANION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMIN
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:KYLE
Authorized Official - Last Name:VITALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-466-3050
Mailing Address - Street 1:810 BEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-1115
Mailing Address - Country:US
Mailing Address - Phone:203-545-4654
Mailing Address - Fax:
Practice Address - Street 1:810 BEDFORD ST
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-1115
Practice Address - Country:US
Practice Address - Phone:203-545-4654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT609379815253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care