PAYSON OUTPATIENT SERVICE CENTER- 2
NPI 1548709173
Community/Behavioral Health in Payson, AZ

NPI Status: Active since February 15, 2017

Contact Information

803 W MAIN ST
PAYSON, AZ
ZIP 85541
Phone: (480) 831-7566

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  • Organization
  • Community/Behavioral Health
  • Accepts Insurance

About PAYSON OUTPATIENT SERVICE CENTER- 2

This page provides the complete NPI Profile along with additional information for Payson Outpatient Service Center- 2, a provider established in Payson, Arizona operating as a Community/behavioral Health. The healthcare provider is registered in the NPI registry with number 1548709173 assigned on February 2017. The practitioner's primary taxonomy code is 251S00000X with license number OTC7954 (AZ). The provider is registered as an organization and their NPI record was last updated 3 years ago. The provider's is doing business as Payson Outpatient Service Center- 2. The authorized official of this NPI record is John Hoegeboom Lisac (President/ceo)

NPI
1548709173
Provider Legal Name
COMMUNITY BRIDGES, INC.
Other Organization Name
PAYSON OUTPATIENT SERVICE CENTER- 2
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
803 W MAIN ST PAYSON, AZ 85541
Location Phone
(480) 831-7566
Mailing Address
1855 W BASELINE RD SUITE 101 MESA, AZ 85202
Mailing Phone
(480) 831-7566
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-15-2017
Last Update Date
02-14-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Community/Behavioral Health

Taxonomy Code
251S00000X
Type
Agencies
License No.
OTC7954
License State
AZ
Taxonomy Description
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1251B00000XAgencies

Case Management

 
2261Q00000XAmbulatory Health Care Facilities

Clinic/Center

 
3291U00000XLaboratories

Clinical Medical Laboratory

OTC7954 (AZ)
4343900000XTransportation Services

Non-emergency Medical Transport (VAN)

OTC7954 (AZ)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Bronze Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Bronze Standard - HMO
  • Catastrophic Standard - HMO
  • Gold Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Gold Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Gold Standard - HMO
  • Silver Complete 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Complete+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx - HMO
  • Silver Elite 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Elite+Dental 4 $0 Tier-1 PCP Visits, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx - HMO
  • Silver Standard - HMO
  • AZ Blue ACA StandardHealth Silver with Health Choice - HMO
  • AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
  • AZ Blue EverydayHealth Gold Focus (1 Free PCP Visit) - HMO
  • AZ Blue EverydayHealth Silver Focus (1 Free PCP Visit) - HMO
  • AZ Blue Portfolio Bronze HSA Focus - HMO
  • AZ Blue StandardHealth Bronze Focus - HMO
  • AZ Blue StandardHealth Gold Focus - HMO
  • AZ Blue StandardHealth Silver Focus - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JOHN HOEGEBOOM LISAC

Authorized Official Title
PRESIDENT/CEO
Authorized Official Phone
(480) 831-7566

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
OTC7954OTHER (01)AZADHS

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1548709173, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
4
Doubled → 8
Pos 4
8
Unchanged
Pos 5
7
Doubled → 14 → 1 + 4
Pos 6
0
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
1
Unchanged
Pos 9
7
Doubled → 14 → 1 + 4
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 4 → 8 7 → 14 → 5 9 → 18 → 9 7 → 14 → 5

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 8 + 8 + 1 + 4 + 0 + 1 + 8 + 1 + 1 + 4 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1548709173.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Counselor (Addiction (Substance Use Disorder))
803 W MAIN ST
PAYSON, AZ 85541
Counselor (Professional)
803 W MAIN ST
PAYSON, AZ 85541
Community/Behavioral Health
803 W MAIN ST
PAYSON, AZ 85541

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1548709173, enumerated as an "organization" on February 15, 2017.

The provider is located at 803 W MAIN ST PAYSON, AZ 85541 and the phone number is (480) 831-7566.

Community/Behavioral Health with taxonomy code 251S00000X.

The provider might be accepting Accepts: Antidote Health Plan of Arizona, Inc., Blue Cross. Please consult your insurance carrier or call the provider to verify.