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Organization
HOPEBRIDGE LLC
Active
Organization
HOPEBRIDGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE GRAFF (CONTRACTING & CREDENTIALING MANAGER)
(317) 376-8336
Entity
Organization
Contact information
Practice address
146 SW 134TH STREET, MOORE, OK 73170-1488
(855) 324-0885
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 234-0885
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NULL
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
NULL
103TC0700X
Clinical Psychologist
—
—
106E00000X
Assistant Behavior Analyst
—
NULL
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
NULL
106S00000X
Behavior Technician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
12/03/2021
Last updated
03/03/2022
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