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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