Organization
COMMUNITY BRIDGES, INC.
Active
Other names
CPEC Crisis
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOGEBOOM (PRESIDENT/CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
358 E JAVELINA AVE STE 101, MESA, AZ 85210-6205
(480) 507-3180
Mailing address
1855 W BASELINE RD STE 101, MESA, AZ 85202-9098
(480) 831-7566
(480) 775-2457
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251J00000X
Nursing Care Agency
Primary
OTC6023
AZ
291U00000X
Clinical Medical Laboratory
OTC6023
AZ
343900000X
Non-emergency Medical Transport (VAN)
OTC6023
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
221736
—
AZ
Enumeration date
06/07/2018
Last updated
07/14/2022
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