Freedom Bridge to Recovery LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

FREEDOM BRIDGE TO RECOVERY LLC

Practice address

1307 Magnolia St
Bowling Green, KY 42104-3050

Phone

(270) 791-9943

Fax

(270) 904-2377

NPI assigned

Dec 4, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stacey Denise Hendershot

Title

Administrator

Phone

(270) 791-9943

Specialties & licenses 2

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544659200000",
    "number": "1194295089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 MAGNOLIA ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043050",
            "telephone_number": "270-791-9943",
            "fax_number": "270-904-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 MAGNOLIA ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421043050",
            "telephone_number": "270-791-9943",
            "fax_number": "270-904-2377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1117 Kentucky St",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421012605",
            "country_code": "US",
            "telephone_number": "270-791-9943",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FREEDOM BRIDGE TO RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-04",
        "last_updated": "2018-12-13",
        "status": "A",
        "authorized_official_last_name": "HENDERSHOT",
        "authorized_official_first_name": "STACEY",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "270-791-9943"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194295089",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ambreen Fraser, M.D.
• Asad Fraser, M.D.
• Zahid G Fraser, MD
• Kim Frassinelli, PTA
• Xanxorskii Frazier
• Freedom Bridge to Recovery Multicare LLC
• Freedom Home Care of Kentucky
• Katherine Freeman
• Sarah E Freeman, LPCC-S
• Shelby French, MMFT

• Substance Abuse Rehabilitation Facility in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Substance Abuse Rehabilitation Facility in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.