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Organization

COMMUNITY BRIDGES, INC

Active
Parent organization
COMMUNITY BRIDGES, INC
Other names
Globe SRU & Outpatient Clinic
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
5734 EAST HOPE LANE, GLOBE, AZ 85501
(928) 425-2415
(928) 425-2464
Mailing address
1855 W BASELINE RD, SUITE 101, MESA, AZ 85202-9000
(480) 831-7566
(480) 962-7176

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D2036585
AZ

Other

Enumeration date
08/09/2012
Last updated
08/09/2012
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