COMMUNITY BRIDGES, INC. (NPI# 1417406612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417406612 |
| Entity Type | Organization |
| Organization Name | COMMUNITY BRIDGES, INC. |
| Other Organization Name | DODGE DETOXIFICATION CENTER |
| Practice Address |
2502 N Dodge Blvd Ste 190 Tucson AZ 85716-2675 |
| Mailing Address |
1855 W Baseline Rd Ste 101 Mesa AZ 85202-9098 |
| Practice Telephone | 5206188677 |
| Practice Fax Number | 5203279817 |
| Mailing Telephone | 4808317566 |
| Enumeration Date | 2016-09-28 |
| Last Update Date | 2016-09-29 |
| Authorized Official Name | JOHN HOGEBOON (VICE PRESIDENT) |
| Authorized Official Telephone | 4808317566 |
| Authorized Official Credential | LISAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
IFBH7808 | AZ | Ambulatory Health Care Facilities |
| N | 291U00000X | Clinical Medical Laboratory | IFBH7808 | AZ | Laboratories |
| N | 343900000X | Non-emergency Medical Transport (VAN) | IFBH7808 | AZ | Transportation Services |
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
IFBH7808 | AZ | Ambulatory Health Care Facilities |
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
IFBH7808 | AZ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | LICENSE NUMBER | IFBH7808 | 01 |
| Other Name | Type Code |
|---|---|
| Dodge Detoxification Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417439936 | Community Bridges, Inc. | Clinical Medical Laboratory | 250 S Toole Ave Ste 110, Tucson, AZ 85701-1814 | 2018-08-31 |
| 1346722196 | Community Bridges, Inc. | Clinic/Center | 250 S Toole Ave Ste 130, Tucson, AZ 85701-1814 | 2018-08-29 |
| 1831678721 | Community Bridges, Inc. | Nursing Care | 1520 E Pima St Ste 101, Phoenix, AZ 85034-4639 | 2018-08-10 |
| 1972099836 | Community Bridges, Inc. | Nursing Care | 2950 N Dodge Blvd Ste A, Tucson, AZ 85716-2012 | 2018-07-03 |
| 1285127043 | Community Bridges, Inc. | Clinical Medical Laboratory | 358 E Javelina Ave Ste 101, Mesa, AZ 85210-6205 | 2018-06-07 |
| 1861984205 | Community Bridges, Inc. | Case Management | 460 N Mesa Dr Ste 101, Mesa, AZ 85201-5949 | 2018-06-01 |
| 1184136400 | Community Bridges, Inc. | Psychiatric Residential Treatment Facility | 824 N 99th Ave Ste 105, Avondale, AZ 85323-5327 | 2017-10-26 |
| 1568986560 | Community Bridges, Inc. | Case Management | 824 N 99th Ave Ste 108, Avondale, AZ 85323-5327 | 2017-08-01 |
| 1922559624 | Community Bridges, Inc. | Community/Behavioral Health | 1125 W Jackson St, Phoenix, AZ 85007 | 2016-10-18 |
| 1205115631 | Community Bridges, Inc. | Community/Behavioral Health | 824 N 99th Ave, Suite 108, Avondale, AZ 85323-5315 | 2011-08-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | COMMUNITY BRIDGES, INC. | 720 County St., New Bedford, MA 02740 |
| System for Award Management (SAM) Entities | COMMUNITY BRIDGES, INCORPORATED | 8757 Georgia Ave Ste 540, Silver Spring, MD 20910-3751 |
| Street Address |
2502 N DODGE BLVD STE 190 |
| City | TUCSON |
| State | AZ |
| Zip Code | 85716-2675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942450903 | Adrienne Weede | Social Worker | 2502 N Dodge Blvd Ste 190, Tucson, AZ 85716-2675 | 2008-09-26 |
| 1609229574 | Pasadera Behavioral Health Network, Inc. | Substance Abuse Rehabilitation Facility | 2502 N Dodge Blvd Ste 190, Tucson, AZ 85716-2675 | 2016-07-15 |
| 1669853578 | Tamera Preece | Social Worker | 2502 N Dodge Blvd Ste 190, Tucson, AZ 85716-2675 | 2015-06-16 |
| 1679845929 | Rita Jackson-mullen | Counselor | 2502 N Dodge Blvd Ste 190, Tucson, AZ 85716-2675 | 2012-02-02 |
| 1396015145 | Marilyn Kurns | Social Worker | 2502 N Dodge Blvd Ste 190, Tucson, AZ 85716-2675 | 2012-01-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063065043 | Kristi Watson Mdpc | Clinic/Center | Hodges Eye Care and Surgical Location, 1502 N. Tucson Blvd, Tucson, AZ 85716 | 2019-07-19 |
| 1639731326 | Leigh-anne Andre | Social Worker | 1135 N. Jones Blvd, Tucson, AZ 85716 | 2019-07-02 |
| 1053802462 | Thomas Scott Mcvean | Technician, Pathology | 718 N Richey Blvd, Tucson, AZ 85716 | 2018-05-21 |
| 1063923787 | Intermountain Health Center, Inc. | Clinic/Center | 3815 E. Monte Vista, Apt. 1101, Tuscon, AZ 85716 | 2017-10-20 |
| 1992224729 | Rocio Fonseca | Counselor | 1014 N Country Club, Tucson, AZ 85716 | 2017-09-13 |
| 1548784473 | Adrian Linda Fait | Speech-Language Pathologist | Child & Family Resources, Inc., 2800 E. Broadway Blvd, Tucson, AZ 85716 | 2017-08-02 |
| 1447701867 | Katheryn Fredman | Counselor | 3830 E. Bellevue St., Tucson, AZ 85716 | 2016-10-20 |
| 1396114211 | Craig Stark | Internal Medicine | 2978 E Greenlee St, Tucson, AZ 85716 | 2015-09-21 |
| 1598142283 | Layla Carol Bradley | Nurse Practitioner | 3832 E. Speedway, Minute Clinic, Tucson, AZ 85716 | 2015-05-01 |
| 1134547813 | Maeve Shaughnessy | Counselor | 2921 E Fort Lowell Rd Ste 207, Tucson, AZ 85716 | 2014-03-31 |
| Find all providers in zip 85716 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457604126 | Tucson Transitional Living LLC | Clinic/Center | 1309 N Venice Ave, Tucson, AZ 85712-3935 | 2012-10-18 |
| 1922034685 | Valley Hope Association | Clinic/Center | 3275 W Ina Rd, Suite 135, Tucson, AZ 85741-2328 | 2006-06-24 |
| 1902449077 | Hidden Paradox, LLC | Clinic/Center | 4144 E Broadway Blvd, Tucson, AZ 85711-3455 | 2019-10-22 |
| 1235657461 | Arizona Rehab Campus, LLC | Clinic/Center | 6944 E Tanque Verde Rd, Tucson, AZ 85715 | 2017-09-08 |
| 1457802274 | Rincon Recovery, LLC | Clinic/Center | 5956 E Pima St, Ste 140, Tucson, AZ 85712-4375 | 2016-10-17 |
| 1083968549 | The Haven's Outpatient Clinic | Clinic/Center | 2601 N Campbell Ave, Suite 110, Tucson, AZ 85719-3163 | 2012-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538787023 | Irma Behavioral Home LLC | Clinic/Center | 7034 W Irma Ln, Glendale, AZ 85308-9459 | 2020-07-10 |
| 1962022806 | Illuminate Recovery LLC | Clinic/Center | 10619 N Hayden Rd Ste A-108, Scottsdale, AZ 85260-8529 | 2020-04-21 |
| 1154940864 | Light House Group Home LLC | Clinic/Center | 108 E 2nd Ave Ste 101, Mesa, AZ 85210-1410 | 2020-04-13 |
| 1871128520 | Summit Bhc Mesa LLC | Clinic/Center | 860 N Center St Bldg 1-3, Mesa, AZ 85201-4201 | 2020-03-03 |
| 1861025876 | Summit Bhc Mesa LLC | Clinic/Center | 846 North Center Street Suite 101, Mesa, AZ 85201 | 2020-02-18 |
| 1386284982 | Succeeding At Recovery LLC | Clinic/Center | 10702 W Peoria Ave, Sun City, AZ 85351-4062 | 2020-01-10 |
| 1538706775 | Soberman's Estate LLC | Clinic/Center | 5035 E Barwick Dr, Cave Creek, AZ 85331-5981 | 2019-12-06 |
| 1659918266 | Peace & Ease LLC | Clinic/Center | 14362 N Frank Lloyd Wright Blvd Ste B103, Scottsdale, AZ 85260-8881 | 2019-12-02 |
| 1124662788 | Jh Medical Services LLC | Clinic/Center | 4635 W Mcdowell Rd Ste 110, Phoenix, AZ 85035-4149 | 2019-11-06 |
| 1609429315 | Blueprints Therapeutic Services LLC | Clinic/Center | 114 S Virginia St, Prescott, AZ 86303-3803 | 2019-07-22 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COMMUNITY BRIDGES, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.