Provider Demographics
NPI:1124514104
Name:UTOPIA HEALTH CENTER
Entity type:Organization
Organization Name:UTOPIA HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:OUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-461-7187
Mailing Address - Street 1:65 DUKE ST
Mailing Address - Street 2:
Mailing Address - City:PRINCE FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:20678-6128
Mailing Address - Country:US
Mailing Address - Phone:301-220-2842
Mailing Address - Fax:301-220-3842
Practice Address - Street 1:65 DUKE ST
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-6128
Practice Address - Country:US
Practice Address - Phone:301-220-2842
Practice Address - Fax:301-220-3842
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UTOPIA HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251S00000X, 261QM0850X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD30024600Medicaid