# BROKEN BOW HEALTH AND REHAB LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Indian Nations Healthcare LLC dba Broken Bow Nursing Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780977462
- **Authorized official:** MRS. GIELA RAYE WILLIAMS RN (ADMINISTRATOR)
- **Authorized official phone:** (580) 584-6433

## Contact information

- **Practice address:** 700 JONES ST., BROKEN BOW, OK 74728-0130
- **Practice address phone:** (580) 584-6433
- **Practice address fax:** (580) 584-2014
- **Mailing address:** PO BOX 130, 700 JONES ST., BROKEN BOW, OK 74728-0130
- **Mailing address phone:** (580) 584-6433
- **Mailing address fax:** (580) 584-2014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH4501 | OK | Yes |

## Other

- **Enumeration date:** 05/27/2011
- **Last updated:** 06/03/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100778050A | — | OK |