Organization
COMMUNITY BRIDGES, INC.
Active
Other names
Holbrook Outpatient Services Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOGEBOOM (PRESIDENT/CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
993 HERMOSA DRIVE, SUITE A, HOLBROOK, AZ 86025
(928) 524-1151
Mailing address
1855 W BASELINE RD STE 101, MESA, AZ 85202-9098
(480) 831-7566
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
7809
AZ
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC7166
LICENSE
AZ
Enumeration date
10/20/2016
Last updated
04/10/2023
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