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Organization
HOPEBRIDGE LLC
Active
Organization
HOPEBRIDGE LLC
Active
Parent organization
HOPEBRIDGE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOPEBRIDGE LLC
Authorized official
ANGIE GRAFF (CREDENTIALING MANAGER)
(317) 376-8336
Entity
Organization
Contact information
Practice address
2147 NEWNAN CROSSING BOULEVARD EAST, NEWNAN, GA 30265
(855) 324-0885
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
11/21/2019
Last updated
11/21/2019
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