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General NPI Number Information
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NPI Number | 1255168027
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Entity Type | Organization
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Legal Business Name | BARAKA TREATMENT CENTER
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Dates
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Enumeration Date | 09/17/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 3014 61ST AVE SW UNIT C
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City | SEATTLE
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State | WA
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Zip | 98116-4725
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Country | US
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Telephone | 206-446-7627
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Fax |
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Provider Business Mailing Address
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Address Line | 4448 31ST AVE S
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City | SEATTLE
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State | WA
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Zip | 98108-1516
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Country | US
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Telephone | 206-446-7627
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HASSAN JANIWADE
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Credential |
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Telephone | 206-446-7627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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