COMMUNITY BRIDGES, INC / WINSLOW OUTPATIENT SERVICES CENTER (NPI# 1851698666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1851698666 |
Entity Type | Organization |
Organization Name | COMMUNITY BRIDGES, INC / WINSLOW OUTPATIENT SERVICES CENTER |
Other Organization Name | WINSLOW OUTPATIENT SERVICES CENTER |
Practice Address |
110 E Second St Winslow AZ 86047-3704 |
Mailing Address |
1855 W. Baseline Rd. Suite 101 Mesa AZ 85202-9098 |
Practice Telephone | 9282891222 |
Practice Fax Number | 9282891122 |
Mailing Telephone | 4808317566 |
Mailing Fax Number | 4809627671 |
Enumeration Date | 2011-02-15 |
Last Update Date | 2015-02-19 |
Authorized Official Name | MR. JOHN 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 | 251S00000X | Community/Behavioral Health | OTC6949 | AZ | Agencies |
N | 251J00000X | Nursing Care | OTC6949 | AZ | Agencies |
N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
OTC6949 | AZ | Ambulatory Health Care Facilities |
N | 261QH0100X |
Clinic/Center Specialization: Health Service |
OTC6949 | AZ | Ambulatory Health Care Facilities |
N | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
OTC6949 | AZ | Ambulatory Health Care Facilities |
N | 261QR1300X |
Clinic/Center Specialization: Rural Health |
OTC6949 | AZ | Ambulatory Health Care Facilities |
N | 291U00000X | Clinical Medical Laboratory | OTC6949 | AZ | Laboratories |
N | 343900000X | Non-emergency Medical Transport (VAN) | OTC6949 | AZ | Transportation Services |
Y | 251B00000X | Case Management | BH-3829 | AZ | Agencies |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AZ | MEDICARE PTAN | Z145164 | 01 |
AZ | 599812 | 05 |
Other Name | Type Code |
---|---|
Winslow Outpatient Services Center | Doing Business As Name - Organization |
Street Address |
110 E SECOND ST |
City | WINSLOW |
State | AZ |
Zip Code | 86047-3704 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770849903 | Community Bridges, Inc | Clinical Medical Laboratory | 110 E Second St, Winslow, AZ 86047-3704 | 2012-04-02 |
1366749491 | Nancy Carol Stehle | Social Worker | 110 E Second St, Winslow, AZ 86047-3704 | 2011-02-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568097350 | Kalp Juthani | Student in an Organized Health Care Education/Training Program | 500 N Indiana Avenue, Winslow, AZ 86047 | 2020-03-11 |
1104461268 | Dental Innovations-winslow | Clinic/Center | 722 Mike's Pike Street, #101, Winslow, AZ 86047 | 2019-11-13 |
1417505611 | Association of Indigenous Pioneers, Incorporated (aipi) | Non-emergency Medical Transport (VAN) | Nec Navajo Route 15 & 60, Suite #2, Winslow, AZ 86047 | 2019-08-30 |
1790347573 | Wilfred Shirley | Counselor | 1/2 Mile Northeast Dilkon Bashas Store, Winslow, AZ 86047 | 2019-07-02 |
1871055624 | Mark Ashcraft | Student in an Organized Health Care Education/Training Program | Winslow Indian Health Care Center, 500 North Indiana Ave, Winslow, AZ 86047 | 2019-04-02 |
1568928521 | Winslow Indian Health Care Center, Inc | Pharmacy | 1.5 Mile N. Leupp Chapter House, Leupp, AZ 86047 | 2019-02-14 |
1659837615 | Winslow Indian Health Care Center, Inc | Pharmacy | 3 Mls S. of Dilkon Chapter Hse., Dilkon, AZ 86047 | 2019-02-14 |
1750809836 | Grassroots Medical Supply | Durable Medical Equipment & Medical Supplies | Nec Navajo Route 15 and 60, Suite #2, Winlsow, AZ 86047 | 2017-09-08 |
1538697396 | Janell K Dickson | Counselor | 1/4 Mile Ne of Bashas, Dilkon, AZ 86047 | 2017-05-24 |
1235599143 | Dennis Peters | Veterinarian | 4301 W Highway 66, Winslow, AZ 86047 | 2016-03-04 |
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Taxonomy Code | 251B00000X |
Grouping | Agencies |
Classification | Case Management |
An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194933655 | Town of Winslow | Case Management | 55 Benton Ave, Winslow, ME 04901 | 2007-05-18 |
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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.