OrganizationActive
Baraka House LLC
NPI 1104084383 · Assisted Living Facility (Mental Illness) · Phoenix, AZ
Provider details
- NPI number
- 1104084383
- Entity type
- Organization
- Primary specialty
- Assisted Living Facility (Mental Illness)Nursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Victor Okorie, Director(602) 524-0824
- License
- BH 3059 (AZ)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
13619 N 36th Ave
Phoenix, AZ 85029-1103
Phone: (602) 824-9100
Fax: (602) 249-8900
Approximate (ZIP-level) locationGet directions
Mailing address
10000 N 31st Ave Ste A107
Phoenix, AZ 85051-9582
Other names (DBA / former)
- Doing business as
- Baraka House
Registry dates
- Enumerated
- 2008-05-24
- Last updated
- 2022-04-13
- Certified
- 2022-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.