NPIMap

Organization Active NPI

Community Bridges, Inc.

Doing business as Dodge Center

  • Mental Illness Community Based Residential Treatment Facility
  • Tucson, AZ
National Provider Identifier
1871049775
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
COMMUNITY BRIDGES, INC.
Doing business as
Dodge Center
Practice address
2950 N Dodge Blvd
Tucson, AZ 85716-2012
Phone
(877) 931-9142
NPI assigned
Aug 30, 2016
Last updated
Jan 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Authorized official

Name
John Hogeboom, LISAC
Title
President/Ceo
Phone
(480) 831-7566

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X BH4997 AZ
Mental Illness Community Based Residential Treatment Facility 320800000X Primary
Psychiatric Residential Treatment Facility 323P00000X BH4997 AZ
Substance Abuse Rehabilitation Facility 324500000X BH4997 AZ
Non-emergency Medical Transport (VAN) 343900000X BH4997 AZ
Respite Care 385H00000X BH4997 AZ

Addresses

Primary practice location

2950 N Dodge Blvd
Tucson, AZ 85716-2012

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
BH4997OtherAZADHS

Other names 1

  • Dodge Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2118151Dodge Center2950 N Dodge Blvd, Tucson, AZ 85716Certificate of waiverAug 30, 2026
03D2150766Dodge Outpatient Service Center2950 N Dodge Blvd, Suite a, Tucson, AZ 85716Certificate of waiverJul 2, 2026

National Provider Directory

National Provider Directory
Tax ID family
Community Bridges Inc66 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1871049775",
    "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": "2950 N DODGE BLVD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857162012",
            "telephone_number": "877-931-9142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BRIDGES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-30",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "HOGEBOOM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "480-831-7566",
        "authorized_official_credential": "LISAC"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "BH4997",
            "primary": false
        },
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "AZ",
            "license": "BH4997",
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "AZ",
            "license": "BH4997",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AZ",
            "license": "BH4997",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "AZ",
            "license": "BH4997",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADHS",
            "identifier": "BH4997",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dodge Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dodge 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 Jan 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.