Organization
COMMUNITY BRIDGES, INC.
Active
Other names
Central City Addiction Recovery Center
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
2770 E VAN BUREN ST, PHOENIX, AZ 85008-6088
(602) 273-9999
(602) 273-9040
Mailing address
1855 W. BASELINE RD., SUITE 101, MESA, AZ 85202-9098
(480) 831-7566
(480) 831-7563
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
IFBH6374
AZ
261QP2300X
Primary Care Clinic/Center
IFBH6374
AZ
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
IFBH6374
AZ
291U00000X
Clinical Medical Laboratory
IFBH6374
AZ
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
IFBH6374
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
382935
—
AZ
01
—
Z145163
MEDICARE PTAN
AZ
Enumeration date
04/04/2007
Last updated
01/17/2023
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