Organization
COMMUNITY BRIDGES, INC.
Active
Organization
COMMUNITY BRIDGES, INC.
Active
Other names
SMI Supportive Housing Team
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN HOGEBOOM (DEPUTY CEO)
(480) 831-7566
Entity
Organization
Contact information
Practice address
824 N 99TH AVE STE 108, AVONDALE, AZ 85323-5327
(623) 907-1457
Mailing address
1855 W BASELINE RD STE 101, MESA, AZ 85202-9098
(480) 831-7566
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
OTC5972
AZ
251S00000X
Community/Behavioral Health Agency
Primary
OTC5972
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OTC5972
ADHS
AZ
Enumeration date
12/13/2017
Last updated
12/13/2017
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