BARAKA HOUSE LLC (NPI# 1548582679) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548582679 |
| Entity Type | Organization |
| Organization Name | BARAKA HOUSE LLC |
| Practice Address |
15402 N 29th Ave Phoenix AZ 85053-4003 |
| Mailing Address |
5709 W Windrose Dr Glendale AZ 85304-1859 |
| Practice Telephone | 6029420064 |
| Practice Fax Number | 6029420064 |
| Mailing Telephone | 6234860721 |
| Mailing Fax Number | 6022498900 |
| Enumeration Date | 2010-02-16 |
| Last Update Date | 2010-02-24 |
| Authorized Official Name | MRS. ZAHRA C. M. PLAGENS (OWNER/DIRECTOR) |
| Authorized Official Telephone | 6235701138 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
BH3522 | AZ | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 497358 | 05 | |
| AZ | ARIZONA BEHAVIORAL HEALTH LICENSE | BH3522 | 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 |
| 1104084383 | Baraka House LLC | Assisted Living Facility | 13619 N 36th Ave, Phoenix, AZ 85029-1103 | 2008-05-24 |
| 1356780563 | Baraka House LLC | Community Based Residential Treatment Facility, Mental Illness | 7445 W Cheryl Dr, Peoria, AZ 85345-6722 | 2013-06-20 |
| Street Address |
15402 N 29TH AVE |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85053-4003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871065615 | Valley Addiction & Mental Health Services LLC | Nurse Practitioner | 16845 N. 29th Ave, Ste 1-211, Phoenix, AZ 85053 | 2018-12-18 |
| 1417439100 | Amanda M Sherwin | Dietitian, Registered | 15640 N 28h Drive, Phoenix, AZ 85053 | 2018-08-30 |
| 1568970135 | Sage Counseling, Inc. | Community/Behavioral Health | 2734 W Bell Rd., #1385 & 1390, Phoenix, AZ 85053 | 2018-01-17 |
| 1366966434 | Penny L Reamer | Registered Nurse | 17624 N. 31st Ave., Phoenix, AZ 85053 | 2017-08-01 |
| 1043749302 | Jacob Stephen Lawrence | Occupational Therapy Assistant | 3116 W. Hartford Dr., Phoenix, AZ 85053 | 2017-06-08 |
| 1770022923 | Horizon Dental Group West Valley | Dentist | 4025 W. Bell Road, Suite 20, Phoenix, AZ 85053 | 2017-02-21 |
| 1235594938 | Linda Thi Trinh | Optometrist | 16020 North 35th Ave Suite #2, Phoenix, AZ 85053 | 2015-12-22 |
| 1003230301 | Continuum Group West, LLC. | Clinic/Center | 3710 W Greenway Rd, Suite 104, Phoenix, AZ 85053 | 2014-02-07 |
| 1831539410 | Michelle Lea Byers | Nurse Practitioner | 17624 North 31st Ave, Phoenix, AZ 85053 | 2013-06-27 |
| 1437446580 | Candace Faith Gershkovich | Dentist | 4235 W. Thunderbird Rd, Phoenix, AZ 85053 | 2011-07-08 |
| Find all providers in zip 85053 | ||||
| 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 |
| 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 |
| 1104084383 | Baraka House LLC | Assisted Living Facility | 13619 N 36th Ave, Phoenix, AZ 85029-1103 | 2008-05-24 |
| 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.