Organization
COMMUNITY BRIDGES, INC.
Active
Parent organization
COMMUNITY BRIDGES, INC.
Other names
West Valley Access Point
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY BRIDGES, INC.
Authorized official
JOHN F HOGEBOOM LISAC (PRESIDENT/CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
824 N 99TH AVE, SUITE 107-108, AVONDALE, AZ 85323-5315
(480) 831-7566
Mailing address
1855 W. BASELINE RD., SUITE 101, MESA, AZ 85202-9098
(480) 831-7566
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
OTC5972
AZ
251J00000X
Nursing Care Agency
OTC5972
AZ
251S00000X
Community/Behavioral Health Agency
Primary
OTC5972
AZ
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
OTC5972
AZ
261QM0850X
Adult Mental Health Clinic/Center
OTC5972
AZ
261QP2300X
Primary Care Clinic/Center
OTC5972
AZ
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
OTC5972
AZ
291U00000X
Clinical Medical Laboratory
OTC5972
AZ
343900000X
Non-emergency Medical Transport (VAN)
OTC5972
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC5972
ADHS
AZ
01
—
Z145163
MEDICARE PTAN
AZ
Enumeration date
08/16/2011
Last updated
02/14/2023
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