BARAKA HOUSE LLC (NPI# 1104084383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104084383 |
| Entity Type | Organization |
| Organization Name | BARAKA HOUSE LLC |
| Practice Address |
13619 N 36th Ave Phoenix AZ 85029-1103 |
| Mailing Address |
5709 W Windrose Dr Glendale AZ 85304-1859 |
| Practice Telephone | 6028249100 |
| Practice Fax Number | 6022498900 |
| Mailing Telephone | 6028249100 |
| Mailing Fax Number | 6022498900 |
| Enumeration Date | 2008-05-24 |
| Last Update Date | 2008-05-24 |
| Authorized Official Name | MRS. ZAHRA C. M. PLAGENS (DIRECTOR) |
| Authorized Official Telephone | 6235701138 |
| Authorized Official Credential | CNA, BHT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
BH 3059 | AZ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AZ OBHL | BH 3059 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396145694 | Baraka House LLC | Community Based Residential Treatment Facility, Mental Illness | 3302 W Mescal St, Phoenix, AZ 85029-4114 | 2014-08-25 |
| 1548582679 | Baraka House LLC | Assisted Living Facility | 15402 N 29th Ave, Phoenix, AZ 85053-4003 | 2010-02-16 |
| 1356780563 | Baraka House LLC | Community Based Residential Treatment Facility, Mental Illness | 7445 W Cheryl Dr, Peoria, AZ 85345-6722 | 2013-06-20 |
| Street Address |
13619 N 36TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85029-1103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477153799 | Haydee Bermudez | Counselor | 3301 North 33rd Ave., Phoenix, AZ 85029 | 2020-10-27 |
| 1871191221 | Covenant Home Health LLC | In Home Supportive Care | 11830 N. 19th Ave, Suite 101 Pendleton, Phoenix, AZ 85029 | 2020-10-16 |
| 1508406745 | Tailored 2 U Psychiatry, Pllc | Nurse Practitioner | 4150 W Peoria Avenue, Suite 116, Phoenix, AZ 85029 | 2020-01-15 |
| 1770125403 | Desert Gem Assisted Living Facility, LLC | Custodial Care Facility | 3236 W. Eugie Avenue, Phoenix, AZ 85029 | 2019-10-15 |
| 1588128623 | Anna Debbs | Counselor | 11221 North 28th Drive, Bldg E, Phoenix, AZ 85029 | 2019-01-23 |
| 1609360007 | Melissa Lynn Denton | Specialist/Technologist | 4014 W Paradise Dr, Phoenix, AZ 85029 | 2018-06-19 |
| 1275038713 | Jamilah Amirah | Behavioral Analyst | 11024 N 28th Dr Ste 110, Phoenix, AZ 85029 | 2018-03-27 |
| 1639687056 | Empower Home Care, LLC. | Home Health | 11225 N 28th Drive, Suite D115e, Phoenix, AZ 85029 | 2018-01-19 |
| 1467975698 | Samantha June Collett | Nurse Practitioner | 3201 W Peoria Ave Ste 804, Phoenix, AZ 85029 | 2017-07-19 |
| 1073966347 | Meka Joi Green | Social Worker | 11225 M 28th Dr, Suite C210, Phoenix, AZ 85029 | 2016-07-21 |
| Find all providers in zip 85029 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| 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 with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847664 | Young Life Al Inc. | Assisted Living Facility | 2334 W Rancho Dr, Phoenix, AZ 85015-2211 | 2020-09-29 |
| 1811526148 | Phoenix Comfort Homes LLC | Assisted Living Facility | 17643 N 17th St, Phoenix, AZ 85022-2113 | 2020-04-07 |
| 1225697386 | Alpine Villa LLC | Assisted Living Facility | 2144 W Luke Ave, Phoenix, AZ 85015-2319 | 2019-06-11 |
| 1225510118 | Adagio Luxury 4 LLC | Assisted Living Facility | 1045 E Bethany Home Rd, Phoenix, AZ 85014-2229 | 2018-09-06 |
| 1528446648 | Prats Care Home L.L.C. | Assisted Living Facility | 13401 N 30th St, Phoenix, AZ 85032-6028 | 2015-05-08 |
| 1871914408 | A1 Universal Care Inc | Assisted Living Facility | 2529 W Vista Ave, 102, Phoenix, AZ 85051-6783 | 2013-12-27 |
| 1548582679 | Baraka House LLC | Assisted Living Facility | 15402 N 29th Ave, Phoenix, AZ 85053-4003 | 2010-02-16 |
| 1902034424 | Brett Calabro's Home | Assisted Living Facility | 4002 W Sharon Ave, Phoenix, AZ 85029-1044 | 2009-06-23 |
| 1013172352 | Visionz Alliance LLC | Assisted Living Facility | 351 W Sumerset Dr, Phoenix, AZ 85023-7425 | 2008-07-25 |
| 1609079235 | Baraka House | Assisted Living Facility | 3740 W Caron St, Phoenix, AZ 85051-3340 | 2007-06-10 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.