COMMUNITY BRIDGES, INC.; NPI #1417320961

Contact Information

COMMUNITY BRIDGES, INC.

358 E JAVELINA AVE STE 102
MESA, AZ 85210-6205

Phone: 480-831-7566
Fax: 480-962-7671
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Substance Abuse Disorder Rehabilitation Facility	324500000X
Adult Mental Health	261QM0850X
Clinical Medical Laboratory	291U00000X	69	Clinical Laboratory
Health Service	261QH0100X
Mental Health (Including Community Mental Health Center)	261QM0801X	B4[14]	Community Mental Health Center
Rehabilitation, Substance Use Disorder	261QR0405X

Indicates primary specialty

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NPI Profile & details for COMMUNITY BRIDGES, INC.

NPI Number 1417320961

LBN Legal business name COMMUNITY BRIDGES, INC.

Authorized official JOHN HOGEBOOM - (PRESIDENT/CEO)

Entity Organization

Organization subpart ¹ No

Enumeration date 11/05/2015

Last updated 01/17/2023 - About 3 years ago

Identifiers

AZ	License #	IFBH7331
AZ	Medicaid	083505

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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