COMMUNITY BRIDGES INC. NPI 1245610567

NPI Information

NPI: 1245610567
Provider Name: COMMUNITY BRIDGES, INC.

Doing Business As: ALBERT LONG RESIDENTIAL PROGRAM

Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address:
993 HERMOSA DR
AREA B
HOLBROOK, AZ
ZIP 86025
Phone: (928) 524-1151
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COMMUNITY BRIDGES, INC. is a community based residential treatment facility mental illness in Holbrook, 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 1245610567. The provider is registered as an organization entity type.
The provider Is Doing Business As Albert Long Residential Program.

The provider's business location address is:

993 HERMOSA DR
AREA B
HOLBROOK, AZ
ZIP 86025-036
Phone: (928) 524-1151

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 enumeration date for this NPI number is 6/2/2015 and was last updated on 1/2/2023.

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	323P00000X	Psychiatric Residential Treatment Facility	BH4570	ARIZONA	No
2	324500000X	Substance Abuse Rehabilitation Facility	BH4570	ARIZONA	No
3	320800000X	Community Based Residential Treatment Facility, Mental Illness			Yes

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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