Provider Demographics
NPI:1811733736
Name:BAOBAB PSYCHIATRIC SERVICES OF COLORADO, PLLC
Entity type:Organization
Organization Name:BAOBAB PSYCHIATRIC SERVICES OF COLORADO, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KOMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOKOU-ABI
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:512-655-3104
Mailing Address - Street 1:1905 N SHERMAN ST STE 2001433
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-1140
Mailing Address - Country:US
Mailing Address - Phone:512-655-3104
Mailing Address - Fax:833-955-3628
Practice Address - Street 1:1905 N SHERMAN ST STE 2001433
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-1140
Practice Address - Country:US
Practice Address - Phone:512-655-3104
Practice Address - Fax:833-955-3628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty