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
1537 FRANKLIN RD STE 100, BRENTWOOD, TN 37027-6842
(855) 234-0885
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 234-0885
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q070631
—
TN
Enumeration date
12/03/2021
Last updated
12/14/2021
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