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Organization
BROKEN ARROW NURSING HOME INC
Active
Organization
BROKEN ARROW NURSING HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOANNA MAE COOPER (OWNER OPERATOR)
(918) 251-5343
Entity
Organization
Contact information
Practice address
424 N DATE AVE, BROKEN ARROW, OK 74012-3872
(918) 251-5343
(918) 258-9942
Mailing address
424 N DATE AVE, BROKEN ARROW, OK 74012-3872
(918) 251-5343
(918) 258-9942
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
7205
OK
314000000X
Skilled Nursing Facility
Primary
7205
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100772960A
—
OK
Enumeration date
03/22/2007
Last updated
03/11/2016
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