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.
105 N COTTONWOOD AVE
WINSLOW, AZ86047-4011
Phone: 928-289-3151
Fax: 928-289-2444
Website:
Specialty Taxonomy Code
* Substance Abuse Disorder Rehabilitation Facility 324500000X
Clinical Medical Laboratory 291U00000X
Non-emergency Medical Transport (VAN) 343900000X
Rural Health 261QR1300X

* Indicates primary specialty

NPI Profile & details for COMMUNITY BRIDGES, INC.

NPI Number 1881836807
Legal business name
LBN
COMMUNITY BRIDGES, INC.
Authorized official JOHN HOGEBOOM - (PRESIDENT/CEO)
Entity Organization
Organization subpart No
Enumeration date 04/06/2009
Last updated 07/14/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers
  • AZ License #: SABH6349
  • AZ Medicaid: 422788

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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