Organization
COMMUNITY BRIDGES, INC.
Active
Other names
Phoenix Rise
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOGEBOOM (PRESIDENT/CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
1125 W JACKSON ST, PHOENIX, AZ 85007-3110
(480) 831-7566
Mailing address
1855 W BASELINE RD, STE. #101, MESA, AZ 85202-9000
(480) 831-7566
(480) 831-7563
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC9247
ADHS
AZ
Enumeration date
10/18/2016
Last updated
01/13/2023
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