Organization
COMMUNITY BRIDGES, INC.
Active
Other names
CBI - Encompass Colorado City Outpatient
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOGEBOOM (PRESIDENT/CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
50 WEST TOWNSHIP AVENUE, COLORADO CITY, AZ 86021
(480) 831-7566
Mailing address
1855 W BASELINE RD STE 101, MESA, AZ 85202-9098
(480) 831-7566
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC11791
ADHS
AZ
Enumeration date
06/30/2022
Last updated
09/18/2024
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