Provider Demographics
NPI:1568890762
Name:UTOPIA IN HOME CARE SOLUTION
Entity Type:Organization
Organization Name:UTOPIA IN HOME CARE SOLUTION
Other - Org Name:HOME CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREJE
Authorized Official - Middle Name:G
Authorized Official - Last Name:LULU
Authorized Official - Suffix:
Authorized Official - Credentials:NAC
Authorized Official - Phone:206-549-9648
Mailing Address - Street 1:8621 244TH ST SW
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-9062
Mailing Address - Country:US
Mailing Address - Phone:206-549-9648
Mailing Address - Fax:121-334-8920
Practice Address - Street 1:14100 LINDEN AVE N APT 418
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-7165
Practice Address - Country:US
Practice Address - Phone:206-549-9648
Practice Address - Fax:121-334-8920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-24
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAIHS.FS.60405684OtherDEPARTMENT OF HEALTH