COMMUNITY BRIDGES, INC. (NPI# 1003102120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003102120 |
| Entity Type | Organization |
| Organization Name | COMMUNITY BRIDGES, INC. |
| Other Organization Name | CASA GRANDE INPATIENT |
| Practice Address |
675 E Cottonwood Ln Ste 140 Casa Grande AZ 85122-2023 |
| Mailing Address |
1855 W. Baseline Rd. Suite 101 Mesa AZ 85202-9098 |
| Practice Telephone | 5204260088 |
| Mailing Telephone | 4808317566 |
| Mailing Fax Number | 4809627671 |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2018-10-17 |
| Authorized Official Name | JOHN F HOGEBOOM (DEPUTY CEO) |
| Authorized Official Telephone | 4808317566 |
| Authorized Official Credential | LISAC |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY BRIDGES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 291U00000X | Clinical Medical Laboratory | IFBH9071 | AZ | Laboratories |
| N | 343900000X | Non-emergency Medical Transport (VAN) | IFBH9071 | AZ | Transportation Services |
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
IFBH9071 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | MEDICARE PTAN | Z145164 | 01 |
| AZ | ADHS | IFBH9071 | 01 |
| Other Name | Type Code |
|---|---|
| Casa Grande Inpatient | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 675 E Cottonwood Ln, Suite 104, Casa Grande, AZ 85122 | 5204260088 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417439936 | Community Bridges, Inc. | Clinical Medical Laboratory | 250 S Toole Ave Ste 110, Tucson, AZ 85701-1814 | 2018-08-31 |
| 1346722196 | Community Bridges, Inc. | Clinic/Center | 250 S Toole Ave Ste 130, Tucson, AZ 85701-1814 | 2018-08-29 |
| 1831678721 | Community Bridges, Inc. | Nursing Care | 1520 E Pima St Ste 101, Phoenix, AZ 85034-4639 | 2018-08-10 |
| 1972099836 | Community Bridges, Inc. | Nursing Care | 2950 N Dodge Blvd Ste A, Tucson, AZ 85716-2012 | 2018-07-03 |
| 1285127043 | Community Bridges, Inc. | Clinical Medical Laboratory | 358 E Javelina Ave Ste 101, Mesa, AZ 85210-6205 | 2018-06-07 |
| 1861984205 | Community Bridges, Inc. | Case Management | 460 N Mesa Dr Ste 101, Mesa, AZ 85201-5949 | 2018-06-01 |
| 1184136400 | Community Bridges, Inc. | Psychiatric Residential Treatment Facility | 824 N 99th Ave Ste 105, Avondale, AZ 85323-5327 | 2017-10-26 |
| 1568986560 | Community Bridges, Inc. | Case Management | 824 N 99th Ave Ste 108, Avondale, AZ 85323-5327 | 2017-08-01 |
| 1922559624 | Community Bridges, Inc. | Community/Behavioral Health | 1125 W Jackson St, Phoenix, AZ 85007 | 2016-10-18 |
| 1205115631 | Community Bridges, Inc. | Community/Behavioral Health | 824 N 99th Ave, Suite 108, Avondale, AZ 85323-5315 | 2011-08-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | COMMUNITY BRIDGES, INC. | 720 County St., New Bedford, MA 02740 |
| System for Award Management (SAM) Entities | COMMUNITY BRIDGES, INCORPORATED | 8757 Georgia Ave Ste 540, Silver Spring, MD 20910-3751 |
| Street Address |
675 E COTTONWOOD LN STE 140 |
| City | CASA GRANDE |
| State | AZ |
| Zip Code | 85122-2023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043857097 | Karen M Garcia | Registered Nurse | 2631 N Brown Avenue, Casa Grande, AZ 85122 | 2019-12-09 |
| 1063060291 | Martha Bollin | Registered Nurse | 2631 N. Brown Ave., Casa Grande, AZ 85122 | 2019-08-30 |
| 1841846920 | Banner Imaging Services LLC | Radiology | 1828 E. Florence Blvd Bldg B Ste 118 & 128, Suite 118 and 128, Casa Grande, AZ 85122 | 2019-08-14 |
| 1629532692 | Kirk Lee Mackley | Physical Therapist | Vibrant Care, 1355 E Florence Blvd #137, Casa Grande, AZ 85122 | 2019-01-24 |
| 1205307436 | Natalie T Trujillo | Physician Assistant | 301 E Cottonwood Ln Ste 1&2, Casa Grande, AZ 85122 | 2018-12-16 |
| 1710455860 | Community Intervention Associates, Inc | Clinic/Center | 1667 N. Trekell Rd, Suite 101 & 102, Casa Grande, AZ 85122 | 2018-11-07 |
| 1245728302 | Jenkins Chiropractic LLC | Chiropractor | 1891 N Trekell Rd Ste 2, Casa Grande, AZ 85122 | 2018-04-24 |
| 1497242408 | Kelly Winnett | Naturopath | 1415 N Trekell Rd Ste 102, Casa Grande, AZ 85122 | 2018-04-16 |
| 1851895783 | Michael Brubaker Counseling | Community/Behavioral Health | 1927 N. Trekell Rd, Ste D, Casa Grande, AZ 85122 | 2018-03-23 |
| 1770095317 | Walmart Stores Inc. | Pharmacy | 1741 E. Florence Blvd, Casa Grande, AZ 85122 | 2017-11-03 |
| Find all providers in zip 85122 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
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| 1922638055 | Lotus Health Arizona | Clinic/Center | 2600 E Southern Ave Ste I3, Tempe, AZ 85282-7738 | 2020-01-16 |
| 1689218687 | Devine Momentum Phoenix | Clinic/Center | 15342 W Turney Ave, Goodyear, AZ 85395-6323 | 2019-11-01 |
| 1588212195 | Tamarria Denga | Clinic/Center | 10000 N 31st Ave Ste D411, Phoenix, AZ 85051-1358 | 2019-08-27 |
| 1932768975 | Evolve Counseling & Behavioral Health Services | Clinic/Center | 1206 E Warner Rd # 203, Gilbert, AZ 85296-3132 | 2019-06-12 |
| 1073171153 | Heart Song Wellness LLC | Clinic/Center | 8617 W Union Hills Dr Ste 100, Peoria, AZ 85382-7001 | 2019-06-03 |
| 1659936680 | Sedona Family Counseling | Clinic/Center | 130 Castle Rock Rd Unit 65, Sedona, AZ 86351-8876 | 2019-05-06 |
| 1043778756 | Aye Wellness, Pllc | Clinic/Center | 2406 S 24th St Ste E100, Phoenix, AZ 85034-6801 | 2019-03-12 |
| Find all providers with the same taxonomy | ||||
| City | CASA GRANDE |
| Zip Code | 85122 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.