Organization
COMMUNITY BRIDGES, INC
Active
Parent organization
COMMUNITY BRIDGES, INC
Other names
Yuma Lighthouse
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY BRIDGES, INC
Authorized official
MR. JOHN HOGEBOOM LISAC (VP/COO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
3250 B EAST 40TH STREET, YUMA, AZ 85365
(928) 341-4220
(928) 344-4457
Mailing address
1855 W BASELINE RD, SUITE 101, MESA, AZ 85202-9000
(480) 831-7566
(480) 692-7671
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D2039695
AZ
Other
Enumeration date
08/09/2012
Last updated
08/09/2012
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