NPIMap

Organization Active NPI

Community Bridges, Inc

  • Community/Behavioral Health Agency
  • Mesa, AZ
National Provider Identifier
1649410705
Registry record updated Jun 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY BRIDGES, INC
Practice address
1811 S Alma School Rd
Suite 160
Mesa, AZ 85210-3001
Phone
(480) 831-7566
NPI assigned
Mar 3, 2009
Last updated
Jun 15, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2009

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

Authorized official

Name
Mr. John Hogeboom, LISACNPI 1619113370
Title
VP/Coo
Phone
(480) 831-7566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X NU
Substance Use Disorder Rehabilitation Hospital Unit 276400000X NU
Clinical Medical Laboratory 291U00000X NU
Substance Abuse Rehabilitation Facility 324500000X NU
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

1811 S Alma School Rd
Suite 160
Mesa, AZ 85210-3001

Mailing address

1811 S Alma School Rd
Suite 160
Mesa, AZ 85210-3001
Phone (480) 831-7566

Other identifiers 1

IdentifierTypeStateIssuer
433653MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Community Bridges66 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

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

View all 24

Locations

1811 S Alma School Rd
Ste 160
Mesa, AZ 85210
Phone (480) 600-0776

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245024000000",
    "number": "1649410705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1811 S ALMA SCHOOL RD",
            "address_2": "SUITE 160",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103001",
            "telephone_number": "480-831-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1811 S ALMA SCHOOL RD",
            "address_2": "SUITE 160",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852103001",
            "telephone_number": "480-831-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BRIDGES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2009-06-15",
        "status": "A",
        "authorized_official_last_name": "HOGEBOOM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "VP/COO",
        "authorized_official_telephone_number": "480-831-7566",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LISAC"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "276400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation, Substance Use Disorder Unit",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "433653",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Jun 15, 2009; 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.