NPI 1063630671

Broken Arrow, LLC

Organisation Assisted Living Facility Broken Arrow, OK

Practice location

Address: 10107 S Garnett Rd, Broken Arrow, OK 74011-1118
Phone: (918) 461-1955
Mailing address: 3723 Fairview Industrial Dr SE, Salem, OR 97302-1177

Authorised official

Name: Jon Harder
Title: Manager
Phone: (503) 485-4600

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X Licence AL7256-7265 (OK)

Other Assisted Living Facility providers in Oklahoma →

Registry record

NPI: 1063630671
Entity type: Organization
NPI issued: 22 Apr 2007
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.