Provider Demographics
NPI:1962564328
Name:COMMUNITY BRIDGES
Entity type:Organization
Organization Name:COMMUNITY BRIDGES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:LOSSANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-225-4153
Mailing Address - Street 1:162 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-225-4153
Mailing Address - Fax:
Practice Address - Street 1:162 PEMBROKE RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-225-4153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3071580Medicaid
NH3101315Medicaid
NH3072349Medicaid
NH3081131Medicaid
NH3101316Medicaid
NH99560054Medicaid
NH99590024Medicaid
NH3081132Medicaid
NH60000004Medicaid
NH3072140Medicaid
NH99560014Medicaid
NH99560063Medicaid
NH99590004Medicaid
NH30531856Medicaid
NH3072339Medicaid
NH3101314Medicaid