# HOPEBRIDGE LLC

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

## Provider details

- **NPI number:** 1821750167
- **Legal business name:** HOPEBRIDGE LLC
- **Authorized official:** ANGIE GRAFF (CONTRACTING & CREDENTIALING MANAGER)
- **Authorized official phone:** (317) 376-8336

## Contact information

- **Practice address:** 220 GRAND REGENCY BLVD, BRANDON, FL 33510-3935
- **Practice address phone:** (813) 709-7989
- **Practice address fax:** (317) 520-8200
- **Mailing address:** 3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
- **Mailing address phone:** (855) 324-0885
- **Mailing address fax:** (317) 520-8200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 103TC0700X | Clinical Psychologist | — | NULL | — |
| 103TC0700X | Clinical Psychologist | — | — | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | NULL | Yes |
| 2084P0804X | Child & Adolescent Psychiatry Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2021
- **Last updated:** 10/13/2021