COMMUNITY BRIDGES INC. NPI 1871049775

NPI Information

NPI: 1871049775
Provider Name: COMMUNITY BRIDGES, INC.

Doing Business As: DODGE CENTER

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization

Address:
2950 N DODGE BLVD
TUCSON, AZ
ZIP 85716
Phone: (877) 931-9142
Get Directions

COMMUNITY BRIDGES, INC. is a community based residential treatment facility mental illness in Tucson, AZ. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. COMMUNITY BRIDGES, INC. NPI is 1871049775. The provider is registered as an organization entity type.
The provider Is Doing Business As Dodge Center.

The provider's business location address is:

2950 N DODGE BLVD
TUCSON, AZ
ZIP 85716-012
Phone: (877) 931-9142

The provider's authorized official is John 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 03D2118151 - other - mental health facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2016 and was last updated on 1/13/2023.

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	License Number	License State	Primary
1	291U00000X	Clinical Medical Laboratory	BH4997	ARIZONA	No
2	323P00000X	Psychiatric Residential Treatment Facility	BH4997	ARIZONA	No
3	324500000X	Substance Abuse Rehabilitation Facility	BH4997	ARIZONA	No
4	343900000X	Non-emergency Medical Transport (VAN)	BH4997	ARIZONA	No
5	385H00000X	Respite Care	BH4997	ARIZONA	No
6	320800000X	Community Based Residential Treatment Facility, Mental Illness			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	BH4997	OTHER	ARIZONA	ADHS

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

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