| Organization Name: | DRAWBRIDGE MEDICAL, LLC |
| NPI Number: | 1033502877 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JONATHAN HAYES (BUSINESS DEVELOPMENT EXECUTIVE) |
| Mailing Address: | 160 Versailles Rd Frankfort |
| State: | KY US |
| Postal Code: | 406013208 |
| Phone Number: | 6784867340 |
| Fax Number: | 6783050531 |
| NPI Enumeration Date: | 03/17/2015 |
| NPI Last Update Date: | 03/17/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |