Organization
COMMUNITY BRIDGES, INC
Active
Organization
COMMUNITY BRIDGES, INC
Active
Other names
Lighthouse
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN F HOGEBOOM LISAC (PRESIDENT/CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
3250 E 40TH ST, ROOM B, YUMA, AZ 85365-7994
(928) 341-4220
Mailing address
1855 W. BASELINE RD., SUITE 101, MESA, AZ 85202-9098
(480) 831-7566
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
BH-3480
AZ
291U00000X
Clinical Medical Laboratory
BH-3480
AZ
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
323P00000X
Psychiatric Residential Treatment Facility
BH-3480
AZ
324500000X
Substance Abuse Rehabilitation Facility
BH-3480
AZ
343900000X
Non-emergency Medical Transport (VAN)
BH-3480
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
488183
—
AZ
01
—
Z148077
MEDICARE PTAN
AZ
Enumeration date
01/08/2010
Last updated
01/13/2023
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