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General NPI Number Information
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NPI Number | 1740914506
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Entity Type | Organization
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Legal Business Name | COMMUNITY BRIDGES, INC.
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Dates
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Enumeration Date | 07/15/2022
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 460 N MESA DR STE 201
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City | MESA
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State | AZ
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Zip | 85201-5957
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Country | US
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Telephone | 480-768-6022
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Fax |
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Provider Business Mailing Address
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Address Line | 1855 W BASELINE RD SUITE 101
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City | MESA
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State | AZ
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Zip | 85202
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Country | US
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Telephone | 480-831-7566
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | JOHN HOGEBOOM
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Credential |
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Telephone | 480-831-7566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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