NPIMap

Organization Active NPI

Community Bridges, Inc.

  • Community/Behavioral Health Agency
  • Mesa, AZ
National Provider Identifier
1124518204
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY BRIDGES, INC.
Practice address
460 N Mesa Dr Ste 201
Mesa, AZ 85201-5957
Phone
(555) 048-0838
NPI assigned
May 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
John Hogeboom
Title
President/Ceo
Phone
(480) 831-7566

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X OTC8918 AZ
Community/Behavioral Health Agency 251S00000X Primary
Clinic/Center 261Q00000X
Health Service Clinic/Center 261QH0100X OTC8918 AZ
Primary Care Clinic/Center 261QP2300X OTC8918 AZ
Clinical Medical Laboratory 291U00000X OTC8918 AZ

Addresses

Primary practice location

460 N Mesa Dr Ste 201
Mesa, AZ 85201-5957

Mailing address

1855 W Baseline Rd Ste 101
Mesa, AZ 85202-9098
Phone (480) 831-7566

Other identifiers 2

IdentifierTypeStateIssuer
OTC8918OtherAZADHS
424605MedicaidAZ

Other names 1

  • Mesa Heritage Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Bridges Inc67 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722556800000",
    "number": "1124518204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 W BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029098",
            "telephone_number": "480-831-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N MESA DR STE 201",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852015957",
            "telephone_number": "555-048-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BRIDGES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A",
        "authorized_official_last_name": "HOGEBOOM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "480-831-7566"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "AZ",
            "license": "OTC8918",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AZ",
            "license": "OTC8918",
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "OTC8918",
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "OTC8918",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADHS",
            "identifier": "OTC8918",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424605",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mesa Heritage Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mesa Heritage Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.