NPIMap

Organization Active NPI

Community Bridges, Inc

Doing business as Center For Excellence

  • Clinical Medical Laboratory
  • Phoenix, AZ
National Provider Identifier
1851667083
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
03D2036539 Issued in AZ
Legal business name
COMMUNITY BRIDGES, INC
Doing business as
Center For Excellence
Practice address
8825 N 23Rd Ave
Suite 100
Phoenix, AZ 85021-4147
Phone
(602) 861-2255
Fax
(602) 861-2288
NPI assigned
Apr 2, 2012
Last updated
Apr 2, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY BRIDGES, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
John Hogeboom, LISAC
Title
VP/Coo
Phone
(480) 831-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 03D2036539 AZ Primary

Addresses

Primary practice location

8825 N 23Rd Ave
Suite 100
Phoenix, AZ 85021-4147

Mailing address

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

Other names 1

  • Center For Excellence Doing business as

National Provider Directory

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

Organizations with this tax ID in the same state 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1851667083",
    "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",
            "fax_number": "480-962-7671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8825 N 23RD AVE",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850214147",
            "telephone_number": "602-861-2255",
            "fax_number": "602-861-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BRIDGES, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY BRIDGES, INC",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "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_credential": "LISAC"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "03D2036539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center For Excellence",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.