Provider Demographics
NPI:1194411819
Name:NEW BRIDGES COMMUNITY SERVICES LLC
Entity type:Organization
Organization Name:NEW BRIDGES COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SALAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-281-9797
Mailing Address - Street 1:2600 E SOUTHERN AVE STE F4
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-7626
Mailing Address - Country:US
Mailing Address - Phone:623-281-9797
Mailing Address - Fax:
Practice Address - Street 1:616 S BEELINE HWY STE 101
Practice Address - Street 2:
Practice Address - City:PAYSON
Practice Address - State:AZ
Practice Address - Zip Code:85541-5380
Practice Address - Country:US
Practice Address - Phone:623-281-9797
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health