Organization
COMMUNITY BRIDGES, INC.
Active
Other names
Winslow Stabilization and Recovery Unit
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
105 N COTTONWOOD AVE, WINSLOW, AZ 86047-4011
(928) 289-3151
(928) 289-2444
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
261QR1300X
Rural Health Clinic/Center
SABH6349
AZ
291U00000X
Clinical Medical Laboratory
SABH6349
AZ
324500000X
Substance Abuse Rehabilitation Facility
Primary
SABH6349
AZ
343900000X
Non-emergency Medical Transport (VAN)
SABH6349
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
422788
—
AZ
Enumeration date
04/06/2009
Last updated
07/14/2022
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