1568890762 NPI number — UTOPIA IN HOME CARE SOLUTION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568890762 NPI number — UTOPIA IN HOME CARE SOLUTION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UTOPIA IN HOME CARE SOLUTION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568890762
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8621 244TH ST SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDMONDS
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98026-9062
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-549-9648
Provider Business Mailing Address Fax Number:
121-334-8920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14100 LINDEN AVE N APT 418
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98133-7165
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-549-9648
Provider Business Practice Location Address Fax Number:
121-334-8920
Provider Enumeration Date:
10/24/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LULU
Authorized Official First Name:
DEREJE
Authorized Official Middle Name:
G
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
206-549-9648

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: IHS.FS.60405684 . This is a "DEPARTMENT OF HEALTH" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".