HOPEBRIDGE, LLC

Provider Demographics

• NPI: 1891820668
• Name: HOPEBRIDGE, LLC
• Entity type: Organization
• Organization Name: HOPEBRIDGE, LLC
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: DIRECTOR OF CREDENTIALING
• Authorized Official - First Name: ANGIE
• Authorized Official - Last Name: GRAFF
• Authorized Official - Phone: 317-376-8336
• Mailing Address - Street 1: 3500 DEPAUW BLVD STE 3070
• Mailing Address - City: INDIANAPOLIS
• Mailing Address - State: IN
• Mailing Address - Zip Code: 46268-6135
• Mailing Address - Country: US
• Mailing Address - Phone: 855-324-0885
• Mailing Address - Fax: 317-520-8200
• Practice Address - Street 1: 1558 E BOULEVARD STE A
• Practice Address - City: KOKOMO
• Practice Address - State: IN
• Practice Address - Zip Code: 46902-2479
• Practice Address - Country: US
• Practice Address - Phone: 765-252-0530
• Practice Address - Fax: 317-520-8200
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-02-22
• Last Update Date: 2025-09-24

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	2084P0804X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Child & Adolescent Psychiatry	Group - Multi-Specialty
No	106E00000X	Behavioral Health & Social Service Providers	Assistant Behavior Analyst		Group - Multi-Specialty
No	103TC0700X	Behavioral Health & Social Service Providers	Psychologist	Clinical	Group - Multi-Specialty
No	2251P0200X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist	Pediatrics	Group - Multi-Specialty
No	225XP0200X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist	Pediatrics	Group - Multi-Specialty
No	235Z00000X	Speech, Language and Hearing Service Providers	Speech-Language Pathologist		Group - Multi-Specialty
No	225X00000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist		Group - Multi-Specialty
No	103K00000X	Behavioral Health & Social Service Providers	Behavior Analyst		Group - Multi-Specialty
No	103T00000X	Behavioral Health & Social Service Providers	Psychologist		Group - Multi-Specialty
No	225100000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist		Group - Multi-Specialty
No	106S00000X	Behavioral Health & Social Service Providers	Behavior Technician		Group - Multi-Specialty
No	208000000X	Allopathic & Osteopathic Physicians	Pediatrics		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
FL	110620804	Medicaid
OK	201036870C	Medicaid
IN	3000013388	Medicaid
IN	300007160	Medicaid
FL	110620810	Medicaid
IN	200533240 A, C-I	Medicaid
FL	110620800	Medicaid
FL	110620803	Medicaid
FL	110620809	Medicaid
IN	200925340A-I	Medicaid
IN	000000975491	Other	ANTHEM
FL	110620808	Medicaid
OK	201036870A	Medicaid
IN	300007369	Medicaid
IN	300007629	Medicaid
KY	7100493250	Medicaid
FL	110620805	Medicaid
IN	300006160	Medicaid
IN	300007293	Medicaid
FL	110620811	Medicaid
FL	110620801	Medicaid
FL	110620806	Medicaid
FL	110620807	Medicaid
IN	300007183	Medicaid