COMMUNITY BRIDGES INC. NPI 1003353244

NPI Information

NPI: 1003353244
Provider Name: COMMUNITY BRIDGES, INC.

Doing Business As: WOMEN'S TRANSITION PROJECT

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

Address:
240 O'HARA AVENUE
BISBEE, AZ
ZIP 85603
Phone: (520) 432-8068
Get Directions

COMMUNITY BRIDGES, INC. is a community based residential treatment facility mental illness in Bisbee, 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 1003353244. The provider is registered as an organization entity type.
The provider Is Doing Business As Women's Transition Project.

The provider's business location address is:

240 O'HARA AVENUE
BISBEE, AZ
ZIP 85603
Phone: (520) 432-8068
Fax: (520) 432-6962

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

The CLIA number assigned to this NPI record is 03D2151552 - other - behavioral health res with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/26/2017 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	324500000X	Substance Abuse Rehabilitation Facility	BH5106	ARIZONA	No
2	343900000X	Non-emergency Medical Transport (VAN)	BH5106	ARIZONA	No
3	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	BH5106	OTHER	ARIZONA	ADHS
2	237236	OTHER	ARIZONA	AHCCCS

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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