NPIMap

Organization Active NPI

Community Bridges, Inc.

  • Nursing Care Agency
  • Tucson, AZ
National Provider Identifier
1215487384
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
IFBH7808 Issued in AZ
Legal business name
COMMUNITY BRIDGES, INC.
Practice address
2502 N Dodge Blvd
Suite 190
Tucson, AZ 85716-2671
Phone
(520) 323-1309
Fax
(520) 323-1315
NPI assigned
Oct 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Authorized official

Name
John Hogeboom, LISAC
Title
VP/Chief Operating Officer
Phone
(480) 831-7566

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Care Agency 251J00000X IFBH7808 AZ Primary
Clinical Medical Laboratory 291U00000X IFBH7808 AZ
Non-emergency Medical Transport (VAN) 343900000X IFBH7808 AZ

Addresses

Primary practice location

2502 N Dodge Blvd
Suite 190
Tucson, AZ 85716-2671

Mailing address

1855 W Baseline Rd
Suite 101
Mesa, AZ 85202-9000
Phone (480) 831-7566

Other identifiers 1

IdentifierTypeStateIssuer
IFBH7808OtherAZADHS

Other names 1

  • Dodge Detoxification Center 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 18

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

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1215487384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 W BASELINE RD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029000",
            "telephone_number": "480-831-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2502 N DODGE BLVD",
            "address_2": "SUITE 190",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857162671",
            "telephone_number": "520-323-1309",
            "fax_number": "520-323-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BRIDGES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "HOGEBOOM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP/CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "480-831-7566",
        "authorized_official_credential": "LISAC"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "AZ",
            "license": "IFBH7808",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "IFBH7808",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AZ",
            "license": "IFBH7808",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADHS",
            "identifier": "IFBH7808",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dodge Detoxification Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.