Chimene Baraka

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

BH9557 Issued in AZ

Practice address

8018 W Cordes Rd
Phoenix, AZ 85043-1443

Phone

(602) 388-0922

NPI assigned

Feb 27, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Devereux Foundation

  • Adolescent and Children Mental Health Clinic/Center
  • Phoenix, AZ
  • NPI 1306939368
  NPD
• The Devereux Foundation

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Scottsdale, AZ
  • NPI 1497852768
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1740046697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 N CENTRAL AVE STE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123520",
            "telephone_number": "602-283-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8018 W CORDES RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850431443",
            "telephone_number": "602-388-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARAKA",
        "first_name": "CHIMENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "AZ",
            "license": "BH9557",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Baraka House
• Baraka House LLC
• Baraka House LLC
• Baraka House LLC
• Baraka House LLC
• Matilda Olajumoke Baraka, M.D., M.P.H.
• Leslie Ann Barakat, MD
• Magdaleen Barakat
• Carole Barake, MD
• Benjamin Paul Chalom Baranes, DMD

• Mental Illness Community Based Residential Treatment Facility in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Illness Community Based Residential Treatment Facility in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.