Baraka House Llc in Phoenix - Assisted Living, Mental Illness
Baraka House Llc - NPI 1104084383
Baraka House Llc is a Assisted Living, Mental Illness in Phoenix, Arizona. Baraka House Llc practices all healthcare services and medical treatments related to Assisted Living, Mental Illness. The NPI Number for Baraka House Llc is 1104084383. The last update date is 2022-04-13.
Baraka House Llc's current location address is 13619 N 36th Ave, Phoenix, Arizona. You can contact this provider via phone number 6028249100 and fax number 6022498900. The mailing address for Baraka House Llc is 13619 N 36th Ave, Phoenix, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Baraka House Llc |
|---|---|
| Address | 13619 N 36th Ave, Phoenix, Arizona |
| Phone Number | 6028249100 |
| Fax Number | 6022498900 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DIRECTOR |
|---|---|
| Authorized Official Name | Okorie Victor |
| Credentials | M.A., PH.D |
| Telephone Number | 6025240824 |
NPI Number Detail
| NPI Number | 1104084383 |
|---|---|
| Provider Enumeration Date | 2008-05-24 |
| Last Updated Date | 2022-04-13 |
Provider Mailing Address Detail
| Address | 13619 N 36th Ave |
|---|---|
| City | Phoenix |
| State | Arizona (AZ) |
| Post Code | 850291103 |
| Phone Number | 6028249100 |
| Fax Number | 6022498900 |
Provider's Primary Taxonomy Detail
| Speciality | Assisted Living, Mental Illness |
|---|---|
| Taxonomy | 3104A0625X |
| Licence No | BH 3059 |
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Definition: A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff w |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| BH 3059 | AZ | AZ OBHL |
Post Comment/ Review Below
What is the unique identifier code issued to Baraka House Llc by the Centers for Medicare & Medicaid Services (CMS)?
The Baraka House Llc has been assigned the NPI (National Provider Identifier) 1104084383. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete street address where Baraka House Llc is physically located?
The Baraka House Llc is physically situated at the following address: 13619 N 36Th Ave, Phoenix, AZ, 850291103.
What is Baraka House Llc's specialized field of practice, and what is the corresponding taxonomy classification code?
The Baraka House Llc's area of specialization is Assisted Living, Mental Illness, and the corresponding taxonomy code that categorizes this field of practice is 3104A0625X.
On what date did the Baraka House Llc receive its 1104084383 assignment from the Centers for Medicare & Medicaid Services?
The Baraka House Llc was assigned its 1104084383 by the Centers for Medicare & Medicaid Services on 2008-05-24.
When was the information regarding Baraka House Llc most recently updated?
The details pertaining to the Baraka House Llc, including its address, specialty, and other relevant information, were last refreshed on 2022-04-13.
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