Provider Demographics
NPI:1760297451
Name:COMMUNITY BRIDGE HOUSING CORP.
Entity type:Organization
Organization Name:COMMUNITY BRIDGE HOUSING CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-941-2345
Mailing Address - Street 1:13770 SAYRE ST
Mailing Address - Street 2:
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342
Mailing Address - Country:US
Mailing Address - Phone:818-941-2345
Mailing Address - Fax:818-698-1450
Practice Address - Street 1:13770 SAYRE ST
Practice Address - Street 2:
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:818-941-2345
Practice Address - Fax:818-698-1450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY BRIDGE HOUSING CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management