National Provider Identifier Database

COMMUNITY BRIDGES INC
Substance Abuse Disorder Rehabilitation Facility

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.


Contact Information

COMMUNITY BRIDGES, INC.
358 E JAVELINA AVE STE 102
MESA, AZ85210-6205
Phone: 480-831-7566
Fax: 480-962-7671
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X
Adult Mental Health 261QM0850X
Clinical Medical Laboratory 291U00000X
Health Service 261QH0100X
Mental Health (Including Community Mental Health Center) 261QM0801X
Rehabilitation, Substance Use Disorder 261QR0405X

* Indicates primary specialty

NPI Profile & details for COMMUNITY BRIDGES, INC.

NPI Number 1417320961
Legal business name
LBN
COMMUNITY BRIDGES, INC.
Authorized official JOHN HOGEBOOM - (PRESIDENT/CEO)
Entity Organization
Organization subpart No
Enumeration date 11/05/2015
Last updated 01/17/2023 - About 3 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: IFBH7331
  • AZ Medicaid: 083505

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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