Organization
COMMUNITY BRIDGES, INC.
Active
Parent organization
COMMUNITY BRIDGES, INC.
Other names
Women's Transition Project
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY BRIDGES, INC.
Authorized official
JOHN HOGEBOOM LISAC (CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
240 O'HARA AVENUE, BISBEE, AZ 85603
(520) 432-8068
(520) 432-6962
Mailing address
1855 W BASELINE RD STE 101, MESA, AZ 85202-9098
(480) 831-7566
(480) 831-7576
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
BH5106
AZ
343900000X
Non-emergency Medical Transport (VAN)
BH5106
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
237236
AHCCCS
AZ
01
—
BH5106
ADHS
AZ
Enumeration date
01/26/2017
Last updated
01/13/2023
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