# HOPEBRIDGE LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** HOPEBRIDGE LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1730727645
- **Legal business name:** HOPEBRIDGE LLC
- **Authorized official:** ANGIE GRAFF (CREDENTIALING MANAGER)
- **Authorized official phone:** (317) 376-8336

## Contact information

- **Practice address:** 6550 E BROADWAY RD STE 110, MESA, AZ 85206-1734
- **Practice address phone:** (806) 720-7724
- **Practice address fax:** (317) 520-8200
- **Mailing address:** 3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 103TH0100X | Health Service Psychologist | — | NULL | — |
| 103TH0100X | Health Service Psychologist | — | — | — |
| 106E00000X | Assistant Behavior Analyst | — | NULL | — |
| 106E00000X | Assistant Behavior Analyst | — | — | — |
| 106S00000X | Behavior Technician | — | NULL | — |
| 106S00000X | Behavior Technician | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |
| 225X00000X | Occupational Therapist | — | NULL | — |
| 225X00000X | Occupational Therapist | — | — | — |
| 235Z00000X | Speech-Language Pathologist | — | NULL | — |
| 235Z00000X | Speech-Language Pathologist | — | — | — |

## Other

- **Enumeration date:** 12/11/2019
- **Last updated:** 09/08/2021