Community Bridges, Inc.
Organization Active NPI Community/Behavioral Health Agency · Phoenix, AZ
NPI 1821583741 · NPPES record last updated Feb 14, 2023
Key facts
- NPI
- 1821583741
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- OTC8969 (AZ)
- Legal business name
- COMMUNITY BRIDGES, INC.
- Practice address
- 1520 E Pima St
Phoenix, AZ 85034-4639 - Phone
- (480) 831-7566
- NPI assigned
- Jun 22, 2018
- Organization subpart
- No
Authorized official
- Name
- John Hogeboom
- Title
- President/Ceo
- Phone
- (480) 831-7566
Corporate family (same tax ID) 24
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D2111919 | Cactus Integrated Care | Certificate of waiver | Apr 17, 2028 |
National Provider Directory
- Tax ID family
- Community Bridges Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | OTC8969 | AZ | |
| Nursing Care Agency | 251J00000X | OTC8969 | AZ | |
| Community/Behavioral Health Agency | 251S00000X | OTC8969 | AZ | Yes |
| Clinic/Center | 261Q00000X | |||
| Health Service Clinic/Center | 261QH0100X | OTC8969 | AZ | |
| Primary Care Clinic/Center | 261QP2300X | OTC8969 | AZ | |
| Clinical Medical Laboratory | 291U00000X | OTC8969 | AZ | |
| Non-emergency Medical Transport (VAN) | 343900000X | OTC8969 | AZ |
Addresses
Primary practice location
1520 E Pima St
Phoenix, AZ 85034-4639
Mailing address
1855 W Baseline Rd Ste 101
Mesa, AZ 85202-9098
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OTC8969 | Other | AZ | ADHS |
Other names
- Cactus Integrated Care
Other providers in Phoenix, AZ
- Community Bridges, Inc.
- Community Bridges, Inc.
- Community Bridges, Inc.
- Community Bridges, Inc.
- Community Bridges, Inc.
- Community Bridges, Inc.
- Community Bridges, Inc.
- Community Bridges, Inc.
- Community Bridges, Inc.
- Community Buildersa
All providers in Phoenix, AZ · Community/Behavioral Health Agency in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.