COMMUNITY BRIDGES INC. NPI 1790419000

NPI Information

NPI: 1790419000
Provider Name: COMMUNITY BRIDGES, INC.

Doing Business As: CBI - ENCOMPASS FREDONIA OUTPATIENT

Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
170 NORTH MAIN STREET
FREDONIA, AZ
ZIP 86022
Phone: (480) 831-7566
Get Directions

COMMUNITY BRIDGES, INC. is an adult mental health clinic center in Fredonia, AZ. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. COMMUNITY BRIDGES, INC. NPI is 1790419000. The provider is registered as an organization entity type.
The provider Is Doing Business As Cbi - Encompass Fredonia Outpatient.

The provider's business location address is:

170 NORTH MAIN STREET
FREDONIA, AZ
ZIP 86022
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 enumeration date for this NPI number is 7/12/2022 and was last updated on 4/14/2023.

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 Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	251B00000X	Case Management		No
2	261QH0100X	Clinic/Center	Health Service	No
3	261QR1300X	Clinic/Center	Rural Health	No
4	261QM0850X	Clinic/Center	Adult Mental Health	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	OTC11792	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

NPI Synchronization or Removal

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