Organization
COMMUNITY BRIDGES, INC.
Active
Organization
COMMUNITY BRIDGES, INC.
Active
Other names
Central City Addiction Recovery Center - Outpatient
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOGEBOOM (PRESIDENT/CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
2770 E VAN BUREN ST RM E, PHOENIX, AZ 85008-6088
(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
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC12004
ADHS
AZ
Enumeration date
12/02/2022
Last updated
04/14/2023
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