Provider Demographics
NPI:1538508783
Name:UTOPIA HEALTH SERVICES
Entity Type:Organization
Organization Name:UTOPIA HEALTH SERVICES
Other - Org Name:PSYCHIATRIC REHABILITATION PROGRAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NA'IMAH
Authorized Official - Middle Name:FAREEDAH
Authorized Official - Last Name:SEDEGAH
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, CRC, NCC
Authorized Official - Phone:301-383-1629
Mailing Address - Street 1:14300 GALLANT FOX LN
Mailing Address - Street 2:SUITE 213
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4003
Mailing Address - Country:US
Mailing Address - Phone:301-383-1629
Mailing Address - Fax:301-383-1632
Practice Address - Street 1:14300 GALLANT FOX LN
Practice Address - Street 2:SUITE 213
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4003
Practice Address - Country:US
Practice Address - Phone:301-383-1629
Practice Address - Fax:301-383-1632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4473261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)