Organization
COMMUNITY BRIDGES, INC
Active
Parent organization
COMMUNITY BRIDGES, INC
Other names
Center For Excellence
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY BRIDGES, INC
Authorized official
JOHN HOGEBOOM LISAC (VP/COO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
8825 N 23RD AVE, SUITE 100, PHOENIX, AZ 85021-4147
(602) 861-2255
(602) 861-2288
Mailing address
1855 W BASELINE RD, SUITE 101, MESA, AZ 85202-9000
(480) 831-7566
(480) 962-7671
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
03D2036539
AZ
Other
Enumeration date
04/02/2012
Last updated
04/02/2012
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