COMMUNITY BRIDGES, INC (NPI# 1295037059) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295037059 |
Entity Type | Organization |
Organization Name | COMMUNITY BRIDGES, INC |
Other Organization Name | BENSON TRANSITION POINT |
Practice Address |
646 W Union St Benson AZ 85602 |
Mailing Address |
1855 W. Baseline Rd. Suite 101 Mesa AZ 85202-9098 |
Practice Telephone | 5205869546 |
Mailing Telephone | 4808317566 |
Mailing Fax Number | 4809627671 |
Enumeration Date | 2010-11-30 |
Last Update Date | 2018-05-17 |
Authorized Official Name | MR. JOHN 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 | BH5166 | AZ | Laboratories |
N | 343900000X | Non-emergency Medical Transport (VAN) | BH5166 | AZ | Transportation Services |
Y | 323P00000X | Psychiatric Residential Treatment Facility | BH5166 | AZ | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | 333267 | 05 | |
AZ | MEDICARE PTAN | Z145164 | 01 |
Other Name | Type Code |
---|---|
Benson Transition Point | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801402417 | Community Bridges, Inc | Counselor | 720 County St, New Bedford, MA 02740-5405 | 2020-09-18 |
1821345752 | Community Bridges, Inc | Clinical Medical Laboratory | 5734 East Hope Lane, Globe, AZ 85501 | 2012-08-09 |
1588920714 | Community Bridges, Inc | Clinical Medical Laboratory | 732 W 4th St, Benson, AZ 85602-6435 | 2012-04-02 |
1033475264 | Community Bridges, Inc | Clinical Medical Laboratory | 993 Hermosa Dr, Holbrook, AZ 86025-2036 | 2012-04-02 |
1699041046 | Community Bridges, Inc | Clinical Medical Laboratory | 554-1 S Bellview, Mesa, AZ 85204-2504 | 2012-03-30 |
1548536378 | Community Bridges, Inc | Clinical Medical Laboratory | 1012 S Stapley Dr Ste 117, Bldg 5, Suite 117, Mesa, AZ 85204-4272 | 2012-03-27 |
1659662468 | Community Bridges, Inc | Case Management | 358 E Javelina Ave, Mesa, AZ 85210-6207 | 2011-04-27 |
1922304310 | Community Bridges, Inc | Case Management | 1012 S Stapley Dr, Bldg 5, Mesa, AZ 85204-4270 | 2011-02-01 |
1699077321 | Community Bridges, Inc | Clinic/Center | 470 S Ocotillo Ave # 2, Benson, AZ 85602 | 2010-12-01 |
1821328113 | Community Bridges, Inc | Community/Behavioral Health | 3250 B East 40th Street, Yuma, AZ 85365 | 2010-01-08 |
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 |
646 W UNION ST |
City | BENSON |
State | AZ |
Zip Code | 85602 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386686509 | Southeastern Arizona Behavioral Health Service, Inc | Psychiatric Residential Treatment Facility | 646 W Union St, Benson, AZ 85602-6713 | 2006-06-12 |
1598012106 | Community Bridges, Inc | Clinical Medical Laboratory | 646 W Union St, Benson, AZ 85602-6713 | 2012-08-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821582529 | Chiricahua Community Health Centers, Inc | Clinic/Center | 335 South Ocotillo Avenue, Benson, AZ 85602 | 2018-06-18 |
1437651288 | Chiricahua Community Health Centers Inc | Pharmacy | 335 S Ocotillo Avenue, Benson, AZ 85602 | 2018-03-07 |
1295191641 | Caring Connections for Special Needs, LLC. | Community/Behavioral Health | 870 W 4th St, Benson, AZ 85602 | 2016-01-14 |
1396158762 | Nicole Michelle Morris | Audiologist | 1989 S. Frontage Rd., Audiology Hearing and Balance Services, Sierra Vista, AZ 85602 | 2014-06-03 |
1467735217 | Josephine Anne Ellsworth | Counselor | 811 Maverick Lane, Benson, AZ 85602 | 2011-09-27 |
1730483819 | Charles Dean Kartchner | Anesthesiology | 1357 East Airport Road, Benson, AZ 85602 | 2011-01-04 |
1699077321 | Community Bridges, Inc | Clinic/Center | 470 S Ocotillo Ave # 2, Benson, AZ 85602 | 2010-12-01 |
1801106844 | Tomas G. Soto | Social Worker | 611 W. Union St., Benson, AZ 85602 | 2010-10-08 |
1982929451 | Marla Jeanne Trepanier | Pharmacist | 795 W Fourth Street, Benson, AZ 85602 | 2010-03-29 |
1396910832 | Susan May Boge | Occupational Therapist | 1764 N Ocotillo Rd, Benson, AZ 85602 | 2008-04-25 |
Find all providers in zip 85602 |
Taxonomy Code | 323P00000X |
Grouping | Residential Treatment Facilities |
Classification | Psychiatric Residential Treatment Facility |
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114096278 | Eckerd Youth Alternatives Inc | Psychiatric Residential Treatment Facility | 876 Root Pond Rd, Benson, VT 05743-9596 | 2006-11-06 |
1386686509 | Southeastern Arizona Behavioral Health Service, Inc | Psychiatric Residential Treatment Facility | 646 W Union St, Benson, AZ 85602-6713 | 2006-06-12 |
1659369569 | Southeastern Arizona Behavioral Health Services, Inc. | Psychiatric Residential Treatment Facility | 470 S Ocotillo Ave, Benson, AZ 85602-6403 | 2005-10-13 |
NPI | Name | Taxonomy | Address | Enumeration |
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1366040123 | Choice Business Strategies LLC | Psychiatric Residential Treatment Facility | 29400 N 123rd Gln, Peoria, AZ 85383-4096 | 2020-10-14 |
1417565292 | Horizon Group Homes LLC | Psychiatric Residential Treatment Facility | 378 E Tropical Dr, Casa Grande, AZ 85122-5086 | 2020-07-17 |
1356969828 | Live Well Assisted Living LLC | Psychiatric Residential Treatment Facility | 9210 W Loow Bend Lane, Phoenix, AZ 85037 | 2020-07-10 |
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1437773942 | Excellent Care LLC | Psychiatric Residential Treatment Facility | 14029 N 39th Ave, Phoenix, AZ 85053-5438 | 2020-06-01 |
1730701517 | Jezzob Behavioral Health LLC | Psychiatric Residential Treatment Facility | 4918 W Apollo Rd, Laveen, AZ 85339-6289 | 2020-05-14 |
1235750977 | Sagamar Behavioral Care Home, LLC | Psychiatric Residential Treatment Facility | 4444 N 13th Pl Apt 3, Phoenix, AZ 85014-4584 | 2020-05-05 |
1508492703 | Rehoboth LLC | Psychiatric Residential Treatment Facility | 41947 W Rosa Dr, Maricopa, AZ 85138-2550 | 2020-03-19 |
1851926661 | Cadens Health and Wellness LLC | Psychiatric Residential Treatment Facility | 5244 W Apollo Rd, Laveen, AZ 85339-6912 | 2020-03-12 |
1114552122 | Angel Heart Behavioral Health IIi LLC | Psychiatric Residential Treatment Facility | 9223 W Meadow Brook, 9223 W Meadow Brook Ave, Phoenix, AZ 85037-8503 | 2020-03-10 |
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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.