Provider Demographics
NPI:1285439893
Name:BAOBAB RESIDENCES
Entity type:Organization
Organization Name:BAOBAB RESIDENCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABINE
Authorized Official - Middle Name:
Authorized Official - Last Name:AJUEYITSI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:646-749-8510
Mailing Address - Street 1:33 35TH ST UNIT A404
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-2252
Mailing Address - Country:US
Mailing Address - Phone:646-749-8510
Mailing Address - Fax:
Practice Address - Street 1:33 35TH ST UNIT A404
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-2252
Practice Address - Country:US
Practice Address - Phone:646-749-8510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities