Organization
COMMUNITY BRIDGES, INC.
Active
Other names
Albert Long Residential Program
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOGEBOOM (PRESIDENT/CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
993 HERMOSA DR, AREA B, HOLBROOK, AZ 86025-2036
(928) 524-1151
Mailing address
1855 W BASELINE RD, SUITE 101, MESA, AZ 85202-9000
(480) 831-7566
(480) 962-7671
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
BH4570
AZ
324500000X
Substance Abuse Rehabilitation Facility
BH4570
AZ
Other
Enumeration date
06/02/2015
Last updated
01/02/2023
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