| Organization Name: | COMMUNITY BRIDGES, INC. |
| NPI Number: | 1700159720 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN F HOGEBOOM (VP/CHIEF OPERATING OFFICER) |
| Mailing Address: | 358 E Javelina Ave Suite 102 Mesa |
| State: | AZ US |
| Postal Code: | 852106207 |
| Phone Number: | 4808317566 |
| Fax Number: | |
| NPI Enumeration Date: | 02/22/2012 |
| NPI Last Update Date: | 02/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 324500000X |
| License Number: | BH-4002 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AZ |
| Taxonomy Type: | Residential Treatment Facilities |
| Taxonomy Classification: | Substance Abuse Rehabilitation Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |