Provider Demographics
NPI:1265182869
Name:ELEVATE PSYCHIATRIC SERVICES
Entity type:Organization
Organization Name:ELEVATE PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:303-842-8885
Mailing Address - Street 1:17970 GYPSUM CANYON CT
Mailing Address - Street 2:
Mailing Address - City:MONUMENT
Mailing Address - State:CO
Mailing Address - Zip Code:80132-7995
Mailing Address - Country:US
Mailing Address - Phone:719-357-8801
Mailing Address - Fax:
Practice Address - Street 1:17970 GYPSUM CANYON CT
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-7995
Practice Address - Country:US
Practice Address - Phone:719-357-8801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR.0068421OtherCOLORADO DEPARTMENT OF REGULATORY AGENCIES
H0093686OtherMARYLAND BOARD OF PHYSICIANS
FLOS15184OtherFLORIDA OSTEOPATHIC MEDICAL ASSOCIATION