Organization
COMMUNITY BRIDGES
Active
Organization
COMMUNITY BRIDGES
Active
Other names
Lift Line
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAYMON CANCINO (CHIEF EXECUTIVE OFFICER)
(831) 688-8840
Entity
Organization
Contact information
Practice address
545 OHLONE PARKWAY, WATSONVILLE, CA 95076-6685
(831) 688-9663
(831) 688-8302
Mailing address
519 MAIN STREET, WATSONVILLE, CA 95076-4356
(831) 688-8840
(831) 688-8302
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MTN00367F
MEDI CAL
CA
01
—
MTN0036F
MEDI CAL
CA
Enumeration date
05/03/2007
Last updated
06/03/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up