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Hopebridge LLC

Psychiatry & Neurology, Child & Adolescent Psychiatry in Brandon, FL. Organization (NPI-2).

NPI number1821750167
StatusActive
Last updated in NPPESOct 13, 2021

Details

NPI
1821750167
Entity type
Organization (NPI-2)
Legal business name
Hopebridge LLC
Organization subpart
Yes
Enumeration date
Oct 13, 2021
Certification date
Sep 28, 2021
Last updated
Oct 13, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry––Yes
103T00000X Psychologist––
103TC0700X Psychologist, Clinical––

Practice location

220 Grand Regency Blvd
Brandon, FL 33510-3935

Phone 813-709-7989 · Fax 317-520-8200

Mailing address

3500 Depauw Blvd Ste 3070
Indianapolis, IN 46268-6135

Phone 855-324-0885 · Fax 317-520-8200

Authorized official

Angie Graff
Contracting & Credentialing Manager
3173768336

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