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NPI Code Detail

MEDICARE: BARAKA BEHAVIORAL HEALTH

MEDICARE: BARAKA BEHAVIORAL HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1255926085
Entity Type Code : Organization
Provider Name (Legal Business Name) : BARAKA BEHAVIORAL HEALTH
Provider Business Mailing Address
First Line : 500 LOCUST ST
Second Line :
City : DES MOINES
State : IA
Zip : 50309-4104
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 LOCUST ST
Second Line :
City : DES MOINES
State : IA
Zip : 50309-4104
Country : US
Telephone Number : 612-987-8717
Fax Number :
Authorized Official
Title or Position : CEO
Name : ANDREW MERANDE
Credential :
Telephone Number : 612-987-8717
Provider Enumeration Date : 03/03/2021
Last Update Date : 03/03/2021

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Directions to “BARAKA BEHAVIORAL HEALTH ” Practice Location

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