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
7445 W CHERYL DR, PEORIA, AZ 85345-6722
(623) 878-0463
(623) 878-0463
Mailing address
10000 N 31ST AVE STE A107, PHOENIX, AZ 85051-9582
(602) 441-2388
(800) 881-7511
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
BH4229
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH4229
BEHAVIORAL HEALTH LICENSE
AZ
Enumeration date
06/20/2013
Last updated
04/13/2022
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