Provider Demographics
NPI:1720490071
Name:UTOPIA, GA LLC
Entity Type:Organization
Organization Name:UTOPIA, GA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:HANSIL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:912-224-0201
Mailing Address - Street 1:54 RIO RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-2330
Mailing Address - Country:US
Mailing Address - Phone:912-224-0201
Mailing Address - Fax:
Practice Address - Street 1:54 RIO RD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-2330
Practice Address - Country:US
Practice Address - Phone:912-224-0201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-14-15949103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty