COMMUNITY BRIDGES INC. NPI 1821328113

NPI Information

NPI: 1821328113
Provider Name: COMMUNITY BRIDGES, INC.

Doing Business As: LIGHTHOUSE

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 03D2075960

Address:
3250 E 40TH ST RM A
YUMA, AZ
ZIP 85365
Phone: (928) 341-4220
Get Directions

COMMUNITY BRIDGES, INC. is a clinic center in Yuma, AZ. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). COMMUNITY BRIDGES, INC. NPI is 1821328113. The provider is registered as an organization entity type.
The provider Is Doing Business As Lighthouse.

The provider's business location address is:

3250 E 40TH ST RM A
YUMA, AZ
ZIP 85365-994
Phone: (928) 341-4220

The provider's authorized official is John F Hogeboom .
The authorized official title is President/ceo and has the following contact phone number (480) 831-7566.

The CLIA number assigned to this NPI record is 03D2075960 - other - outpatient clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/8/2010 and was last updated on 4/10/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251B00000X	Case Management		OTC6332	ARIZONA	No
2	251J00000X	Nursing Care		OTC6332	ARIZONA	No
3	251S00000X	Community/Behavioral Health		OTC6332	ARIZONA	No
4	261QH0100X	Clinic/Center	Health Service	OTC6332	ARIZONA	No
5	261QM0850X	Clinic/Center	Adult Mental Health	OTC6332	ARIZONA	No
6	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	OTC6332	ARIZONA	No
7	291U00000X	Clinical Medical Laboratory		OTC6332	ARIZONA	No
8	343900000X	Non-emergency Medical Transport (VAN)		OTC6332	ARIZONA	No
9	261Q00000X	Clinic/Center				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	Z148077	OTHER	ARIZONA	MEDICARE PTAN
2	221646	MEDICAID	ARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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