Organization
BARAKA HOUSE LLC
Active
Other names
Baraka House
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR OKORIE M.A., PH.D., LPC (OWNER/DIRECTOR)
(602) 524-0824
Entity
Organization
Contact information
Practice address
3302 W MESCAL ST, PHOENIX, AZ 85029-4114
(602) 595-7871
Mailing address
10000 N 31ST AVE STE A107, PHOENIX, AZ 85051-9582
(602) 524-0824
(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
BH4472
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH4472
ADHS
AZ
Enumeration date
08/25/2014
Last updated
04/13/2022
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