Organization
HOPEBRIDGE LLC
Active
Parent organization
HOPEBRIDGE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
HOPEBRIDGE LLC
Authorized official
ANGIE GRAFF (CONTRACTING & CREDENTIALING MANAGER)
(317) 376-8336
Entity
Organization
Contact information
Practice address
220 GRAND REGENCY BLVD, BRANDON, FL 33510-3935
(813) 709-7989
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
10/13/2021
Last updated
10/13/2021
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