Community Bridges, Inc.
Organization Active NPI Adult Mental Health Clinic/Center · Littlefield, AZ
NPI 1801529334 · NPPES record last updated Sep 18, 2024
Key facts
- NPI
- 1801529334
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Mental Health Clinic/Center 261QM0850X
- Legal business name
- COMMUNITY BRIDGES, INC.
- Practice address
- 4103 East Fleet
Suite 100
Littlefield, AZ 86432-5178 - Phone
- (480) 831-7566
- NPI assigned
- Jul 1, 2022
- Organization subpart
- No
Authorized official
- Name
- John Hogeboom
- Title
- President/Ceo
- Phone
- (480) 831-7566
Other NPIs on the same Medicare enrollment 28
Practitioners 5
-
Emina Foci, NP
-
John J Lee, D.O.
-
Marla Jean Van Tassell, NURSE PRACTITIONER
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110606000388 | AZ | Part B Supplier - Clinic/Group Practice | 2062699721 |
Receives reassigned benefits from 126 practitioners 36 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Tucson, AZ; Phoenix, AZ; Payson, AZ; Winslow, AZ; Yuma, AZ; Mesa, AZ; Page, AZ; Avondale, AZ… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | |||
| Health Service Clinic/Center | 261QH0100X | |||
| Adult Mental Health Clinic/Center | 261QM0850X | Yes | ||
| Adolescent and Children Mental Health Clinic/Center | 261QM0855X |
Addresses
Primary practice location
4103 East Fleet
Suite 100
Littlefield, AZ 86432-5178
Mailing address
1855 W Baseline Rd Ste 101
Mesa, AZ 85202-9098
Phone (480) 831-7566
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OTC11793 | Other | AZ | ADHS |
Other names
- CBI - Encompass Littlefield Outpatient
Other providers in Littlefield, AZ
- Wendie G Black
- James Alton Callis Jr.
- Alejandra Camacho
- Canyonlands Community Health Care
- Lacey Bennett Celani
- Encompass Health Services
- Brandon K Finlinson
- Jarrod D Johnson
- Ruth Luck
- Red Hawk Behavioral Health, LLC
All providers in Littlefield, AZ · Adult Mental Health Clinic/Center in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.