COMMUNITY BRIDGES, INC (NPI# 1649425950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649425950 |
Entity Type | Organization |
Organization Name | COMMUNITY BRIDGES, INC |
Other Organization Name | GLOBE TRANSITION POINT |
Practice Address |
5734 Hope Ln Ste 1 Globe AZ 85501 |
Mailing Address |
1855 W. Baseline Rd Suite 101 Mesa AZ 85202-9098 |
Practice Telephone | 9284252415 |
Practice Fax Number | 9284252464 |
Mailing Telephone | 4808317566 |
Mailing Fax Number | 4809627671 |
Enumeration Date | 2008-12-01 |
Last Update Date | 2018-05-17 |
Authorized Official Name | MR. JOHN F HOGEBOOM (VP/COO) |
Authorized Official Telephone | 4808317566 |
Authorized Official Credential | LISAC |
Is Organization Subpart | Y |
Parent Organization Name | COMMUNITY BRIDGES, INC |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
SABH 6693 | AZ | Ambulatory Health Care Facilities |
N | 291U00000X | Clinical Medical Laboratory | SABH 6693 | AZ | Laboratories |
N | 343900000X | Non-emergency Medical Transport (VAN) | SABH 6693 | AZ | Transportation Services |
Y | 323P00000X | Psychiatric Residential Treatment Facility | BH5370 | AZ | Residential Treatment Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | MEDICARE PTAN | Z145164 | 01 |
AZ | 378626 | 05 |
Other Name | Type Code |
---|---|
Globe Transition Point | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801402417 | Community Bridges, Inc | Counselor | 720 County St, New Bedford, MA 02740-5405 | 2020-09-18 |
1821345752 | Community Bridges, Inc | Clinical Medical Laboratory | 5734 East Hope Lane, Globe, AZ 85501 | 2012-08-09 |
1588920714 | Community Bridges, Inc | Clinical Medical Laboratory | 732 W 4th St, Benson, AZ 85602-6435 | 2012-04-02 |
1033475264 | Community Bridges, Inc | Clinical Medical Laboratory | 993 Hermosa Dr, Holbrook, AZ 86025-2036 | 2012-04-02 |
1699041046 | Community Bridges, Inc | Clinical Medical Laboratory | 554-1 S Bellview, Mesa, AZ 85204-2504 | 2012-03-30 |
1548536378 | Community Bridges, Inc | Clinical Medical Laboratory | 1012 S Stapley Dr Ste 117, Bldg 5, Suite 117, Mesa, AZ 85204-4272 | 2012-03-27 |
1659662468 | Community Bridges, Inc | Case Management | 358 E Javelina Ave, Mesa, AZ 85210-6207 | 2011-04-27 |
1922304310 | Community Bridges, Inc | Case Management | 1012 S Stapley Dr, Bldg 5, Mesa, AZ 85204-4270 | 2011-02-01 |
1699077321 | Community Bridges, Inc | Clinic/Center | 470 S Ocotillo Ave # 2, Benson, AZ 85602 | 2010-12-01 |
1821328113 | Community Bridges, Inc | Community/Behavioral Health | 3250 B East 40th Street, Yuma, AZ 85365 | 2010-01-08 |
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 |
5734 HOPE LN STE 1 |
City | GLOBE |
State | AZ |
Zip Code | 85501 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558802884 | Mary Beth Patterson | Pharmacist | 100 S Ragus Rd, Globe, AZ 85501 | 2017-03-20 |
1255873402 | Christopher Sessions | Physician Assistant | 5880 N Hospital Drive, Globe, AZ 85501 | 2016-11-04 |
1235681156 | Michelle Pettitt | Naturopath | 138 S. Broad Street, Globe, AZ 85501 | 2016-10-26 |
1790154664 | Ryan Bradley | Physician Assistant | 5880 N Hospital Dr, Globe, AZ 85501 | 2015-09-21 |
1417297052 | Horizon Health and Wellness, Inc. | Community/Behavioral Health | 2250 Hwy 60, Suite I, Globe, AZ 85501 | 2013-02-19 |
1528307964 | William G Sypult | Internal Medicine | 8036 South Cherokee Drive, Globe, AZ 85501 | 2013-02-05 |
1821345752 | Community Bridges, Inc | Clinical Medical Laboratory | 5734 East Hope Lane, Globe, AZ 85501 | 2012-08-09 |
1417218876 | Canyonlands Community Health Care | Clinic/Center | 5860 South Hospital Drive, Ste 102, Globe, AZ 85501 | 2012-06-01 |
1770841215 | Cv Ob Gyn Women's Healthcare | Obstetrics & Gynecology | 5882 S Hospital Drive, Suite 1, Globe, AZ 85501 | 2012-05-02 |
1235420993 | Jennifer Lyn Davis | Licensed Vocational Nurse | 1300 South Street, Globe, AZ 85501 | 2011-04-28 |
Find all providers in zip 85501 |
Taxonomy Code | 323P00000X |
Grouping | Residential Treatment Facilities |
Classification | Psychiatric Residential Treatment Facility |
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient’s surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary |
Notes: Source: Champus Policy manual, Volume II, p. 6010.47M dated 9/12/94. Revision: Definition title revised 7/1/03 |
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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.