Organization
COMMUNITY BRIDGES, INC.
Active
Other names
Payson Transition Point
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN F HOGEBOOM LISAC (PRESIDENT/CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
803 W MAIN ST STE C, PAYSON, AZ 85541-4993
(928) 468-0022
(928) 468-0044
Mailing address
1855 W BASELINE RD STE 101, MESA, AZ 85202-9098
(480) 831-7566
(480) 962-7671
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
252714
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
252714
AZ
324500000X
Substance Abuse Rehabilitation Facility
252714
AZ
343900000X
Non-emergency Medical Transport (VAN)
252714
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
252714
—
AZ
Enumeration date
08/05/2008
Last updated
01/13/2023
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