Organization
BARAKA HOUSE LLC
Active
Other names
Baraka House
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR OKORIE M.A., PH.D., LPC (DIRECTOR)
(602) 524-0824
Entity
Organization
Contact information
Practice address
13619 N 36TH AVE, PHOENIX, AZ 85029-1103
(602) 824-9100
(602) 249-8900
Mailing address
10000 N 31ST AVE STE A107, PHOENIX, AZ 85051-9582
(602) 441-2388
(800) 524-0824
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
BH 3059
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH 3059
AZ OBHL
AZ
Enumeration date
05/24/2008
Last updated
04/13/2022
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