Provider Demographics
NPI:1700443561
Name:UTOPIAN INSTITUTE OF FAMILY LIVING
Entity Type:Organization
Organization Name:UTOPIAN INSTITUTE OF FAMILY LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HUMAN RESOURCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TENNILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-290-0201
Mailing Address - Street 1:6819 REISTERSTOWN RD STE 203
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-1418
Mailing Address - Country:US
Mailing Address - Phone:443-438-4584
Mailing Address - Fax:443-835-2037
Practice Address - Street 1:6819 REISTERSTOWN RD STE 203
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-1418
Practice Address - Country:US
Practice Address - Phone:443-438-4584
Practice Address - Fax:443-835-2037
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UTOPIAN INSTITUTE OF FAMILY LIVING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-28
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty