NPIMap

Organization Active NPI

Community Bridges, Inc.

Doing business as CCARC Crisis

  • Nursing Care Agency
  • Phoenix, AZ
National Provider Identifier
1891288049
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
213286 Issued in AZ
Legal business name
COMMUNITY BRIDGES, INC.
Doing business as
CCARC Crisis
Practice address
2770 E Van Buren St
Rooms a, B, D
Phoenix, AZ 85008-6088
Phone
(602) 273-9999
NPI assigned
Jun 12, 2018
Last updated
Jul 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Authorized official

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Nursing Care Agency 251J00000X 213286 AZ Primary
Clinical Medical Laboratory 291U00000X 213286 AZ
Non-emergency Medical Transport (VAN) 343900000X 213286 AZ

Addresses

Primary practice location

2770 E Van Buren St
Rooms a, B, D
Phoenix, AZ 85008-6088

Mailing address

1855 W Baseline Rd Ste 101
Mesa, AZ 85202-9098
Phone (480) 831-7566

Other identifiers 1

IdentifierTypeStateIssuer
213286MedicaidAZ

Other names 1

  • CCARC Crisis Doing business as

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 19

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

View all 19

Locations

2770 E Van Buren St
Rm A
Phoenix, AZ 85008
Phone (602) 273-9999

Practitioners & affiliated clinicians

Practitioners 40

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.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1891288049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 W BASELINE RD STE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852029098",
            "telephone_number": "480-831-7566",
            "fax_number": "480-775-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 E VAN BUREN ST",
            "address_2": "ROOMS A, B, D",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086088",
            "telephone_number": "602-273-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY BRIDGES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-12",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "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"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "AZ",
            "license": "213286",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "213286",
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "AZ",
            "license": "213286",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213286",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCARC Crisis",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CCARC Crisis",
            "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 Jul 14, 2022; 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.