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COMMUNITY BRIDGES INC. NPI 1972099836


NPI Information

NPI: 1972099836
Provider Name: COMMUNITY BRIDGES, INC.

Doing Business As: DODGE OUTPATIENT SERVICE CENTER

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 03D2150766

Address:
2950 N DODGE BLVD STE A
TUCSON, AZ
ZIP 85716
Phone: (480) 831-7566
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COMMUNITY BRIDGES, INC. is a community behavioral health in Tucson, AZ. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. COMMUNITY BRIDGES, INC. NPI is 1972099836. The provider is registered as an organization entity type.
The provider Is Doing Business As Dodge Outpatient Service Center.

The provider's business location address is:

2950 N DODGE BLVD STE A
TUCSON, AZ
ZIP 85716-012
Phone: (480) 831-7566

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 03D2150766 - other - behavioral health otc with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/3/2018 and was last updated on 2/14/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251B00000XCase ManagementOTC9000ARIZONANo
2251J00000XNursing CareOTC9000ARIZONANo
3261Q00000XClinic/CenterNo
4261QM0850XClinic/CenterAdult Mental HealthOTC9000ARIZONANo
5261QP2300XClinic/CenterPrimary CareOTC9000ARIZONANo
6291U00000XClinical Medical LaboratoryOTC9000ARIZONANo
7343900000XNon-emergency Medical Transport (VAN)OTC9000ARIZONANo
8251S00000XCommunity/Behavioral HealthYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1OTC9000OTHERARIZONAADHS

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.