COMMUNITY BRIDGES, INC. (NPI# 1134240328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134240328 |
| Entity Type | Organization |
| Organization Name | COMMUNITY BRIDGES, INC. |
| Other Organization Name | EAST VALLEY ADDICTION RECOVERY CENTER |
| Practice Address |
560 S Bellview Mesa AZ 85204-2504 |
| Mailing Address |
1855 W. Baseline Rd Suite 101 Mesa AZ 85202-9098 |
| Practice Telephone | 4809627711 |
| Practice Fax Number | 4808317563 |
| Mailing Telephone | 4809627711 |
| Mailing Fax Number | 4808317563 |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2015-02-13 |
| Authorized Official Name | MR. JOHN F HOGEBOOM (VP/COO) |
| 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 | 251J00000X | Nursing Care | IFBH6337 | AZ | Agencies |
| N | 291U00000X | Clinical Medical Laboratory | IFBH6337 | AZ | Laboratories |
| N | 343900000X | Non-emergency Medical Transport (VAN) | IFBH6337 | AZ | Transportation Services |
| Y | 276400000X | Rehabilitation, Substance Use Disorder Unit | IFBH6337 | AZ | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | MEDICARE PTAN | Z145163 | 01 |
| AZ | 385867 | 05 |
| Other Name | Type Code |
|---|---|
| EAST VALLEY ADDICTION RECOVERY CENTER | Doing Business As Name - Organization |
| 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 |
560 S BELLVIEW |
| City | MESA |
| State | AZ |
| Zip Code | 85204-2504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154812097 | Velma Jean Tucker | Nurse Practitioner | 560 S Bellview, Mesa, AZ 85204 | 2018-05-26 |
| 1275769440 | Community Bridges, Inc | Clinical Medical Laboratory | 560 S Bellview, Mesa, AZ 85204-2504 | 2009-06-02 |
| 1700026846 | Kelley Elaine Downs | Registered Nurse | 560 S Bellview, Mesa, AZ 85204-2504 | 2009-03-03 |
| 1639319759 | Victor De Ocampo Lachica | Registered Nurse | 560 S Bellview, Mesa, AZ 85204-2504 | 2009-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194374819 | Luminations Healing Center, LLC | Social Worker | 1237 S. Val Vista Dr. #221, Mesa, AZ 85204 | 2019-09-05 |
| 1881160356 | Wanjiru Landers | Student in an Organized Health Care Education/Training Program | 550 S Linda Circle, Mesa, AZ 85204 | 2018-10-22 |
| 1649754235 | Adam Desnous | Specialist/Technologist | 751 S Daley, Mesa, AZ 85204 | 2018-09-19 |
| 1982128187 | Michael Anthony Jones | Counselor | 1107 North Gilbert Rd, Mesa, AZ 85204 | 2017-07-29 |
| 1295287225 | Scottsdale Healthcare Corp | Family Medicine | 2530 W. Southern Ave, Mesa, AZ 85204 | 2016-10-25 |
| 1427504158 | Richard White | Physician Assistant | 2345 E Southern Ave # 101, Mesa, AZ 85204 | 2016-09-01 |
| 1548716780 | Pain Stop Accident Injury LLC | Chiropractor | 425 E 11th Ave, Mesa, AZ 85204 | 2016-08-28 |
| 1154704252 | Glenn Taylor Lesueur | Dentist | 1056 S. Val Vista Dr., Suite 1, Mesa, AZ 85204 | 2015-07-07 |
| 1073932513 | Naomi Devine | Nurse Practitioner | 1840 South Stapley Drive, Suite 101, Mesa, AZ 85204 | 2014-04-14 |
| 1609292531 | John Kamau | Counselor | 1060 S Lobin Ln, Mesa, AZ 85204 | 2014-03-17 |
| Find all providers in zip 85204 | ||||
| Taxonomy Code | 276400000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation, Substance Use Disorder Unit |
| A distinct part of a hospital that provides medically monitored, interdisciplinary addiction-focused treatment to patients/clients who have psychoactive substance use disorders (commonly referred to as alcohol and drug abuse or substance abuse.) |
| Notes: Source: Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821616319 | Az Peace of Mind Behavioral Health Home LLC | Rehabilitation, Substance Use Disorder Unit | 15622 W Sierra St, Surprise, AZ 85379-1038 | 2020-07-10 |
| 1265849509 | Tru Recovery Solutions, LLC | Rehabilitation, Substance Use Disorder Unit | 8196 E Valley Rd, Prescott Valley, AZ 86314-9465 | 2014-07-18 |
| 1417391293 | Prescott Detox Center, LLC | Rehabilitation, Substance Use Disorder Unit | 831 Gail Gardner Way, Prescott, AZ 86305-1606 | 2013-04-23 |
| 1215263314 | A Sober Way Home | Rehabilitation, Substance Use Disorder Unit | 609 W Gurley St, Prescott, AZ 86305-3619 | 2009-10-23 |
| 1982894036 | A Sober Way Home | Rehabilitation, Substance Use Disorder Unit | 1211 East Gurley Street, Suite 2, Prescott, AZ 86301 | 2007-07-25 |
| 1912523549 | Buena Vista Recovery, LLC | Rehabilitation, Substance Use Disorder Unit | 3033 S Arizona Ave Ste 110, Chandler, AZ 85248-2717 | 2020-06-19 |
| 1851917488 | Buena Vista Recovery, LLC | Rehabilitation, Substance Use Disorder Unit | 5151 E Pima St Ste 110, Tucson, AZ 85712-3627 | 2020-06-19 |
| 1487126686 | Fjcm Behavioral Health Care LLC | Rehabilitation, Substance Use Disorder Unit | 2710 E Valencia Dr, Phoenix, AZ 85042-7081 | 2018-12-28 |
| 1184103400 | Crossroads, Inc | Rehabilitation, Substance Use Disorder Unit | 1700 E Thomas Rd, Phoenix, AZ 85016-7605 | 2018-08-08 |
| 1457746497 | Pasadera Behavioral Health Network, Inc. | Rehabilitation, Substance Use Disorder Unit | 2502 N Dodge Blvd, Suite 190, Tucson, AZ 85716-2671 | 2015-04-06 |
| Find all providers with the same taxonomy | ||||
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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.