# BROKEN ARROW NURSING HOME INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801913371
- **Authorized official:** MRS. JOANNA MAE COOPER (OWNER OPERATOR)
- **Authorized official phone:** (918) 251-5343

## Contact information

- **Practice address:** 424 N DATE AVE, BROKEN ARROW, OK 74012-3872
- **Practice address phone:** (918) 251-5343
- **Practice address fax:** (918) 258-9942
- **Mailing address:** 424 N DATE AVE, BROKEN ARROW, OK 74012-3872
- **Mailing address phone:** (918) 251-5343
- **Mailing address fax:** (918) 258-9942

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 7205 | OK | — |
| 314000000X | Skilled Nursing Facility | 7205 | OK | Yes |

## Other

- **Enumeration date:** 03/22/2007
- **Last updated:** 03/11/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100772960A | — | OK |