Healthcare Provider Details

I. General information

NPI: 1164346045
Provider Name (Legal Business Name): BRIDGE TO SOBRIETY FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14001 N 7TH ST STE C106
PHOENIX AZ
85022-4344
US

IV. Provider business mailing address

14001 N 7TH ST STE C106
PHOENIX AZ
85022-4344
US

V. Phone/Fax

Practice location:
  • Phone: 602-300-0797
  • Fax:
Mailing address:
  • Phone: 602-300-0797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JOHN AURELIO CABEZAS
Title or Position: OWNER
Credential:
Phone: 480-399-7051