National Provider Identifier Database

COMMUNITY BRIDGES INC
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.

Contact Information

COMMUNITY BRIDGES, INC
3250 E 40TH ST
ROOM B
YUMA, AZ  85365-7994
Phone: 928-341-4220
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Mental Illness 320800000X
Clinical Medical Laboratory 291U00000X
Non-emergency Medical Transport (VAN) 343900000X
Psychiatric Residential Treatment Facility 323P00000X
Rural Health 261QR1300X
Substance Abuse Disorder Rehabilitation Facility 324500000X

* Indicates primary specialty

NPI Profile & details for COMMUNITY BRIDGES, INC

NPI Number 1861722175
Legal business name
LBN		 COMMUNITY BRIDGES, INC
Authorized official JOHN HOGEBOOM - (PRESIDENT/CEO)
Entity Organization
Organization subpart No
Enumeration date 01/08/2010
Last updated 01/13/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: BH-3480
  • AZ Medicaid: 488183
  • AZ Other: Z148077 MEDICARE PTAN

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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