Organization
BROKEN ARROW, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAYNE HANNING (DIRECTOR)
(419) 562-3480
Entity
Organization
Contact information
Practice address
1649 MARION RD, BUCYRUS, OH 44820-3116
(419) 562-3480
Mailing address
1649 MARION RD, BUCYRUS, OH 44820-3116
(419) 562-3480
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0876842
—
OH
Enumeration date
11/17/2020
Last updated
11/17/2020
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