BROKEN ARROW, LLC (NPI# 1063630671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063630671 |
| Entity Type | Organization |
| Organization Name | BROKEN ARROW, LLC |
| Other Organization Name | CEDAR RIDGE AT BROKEN ARROW |
| Practice Address |
10107 S Garnett Rd Broken Arrow OK 74011-1118 |
| Mailing Address |
3723 Fairview Industrial Dr Se Salem OR 97302-1177 |
| Practice Telephone | 9184611955 |
| Mailing Telephone | 5034854600 |
| Enumeration Date | 2007-04-22 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JON HARDER (MANAGER) |
| Authorized Official Telephone | 5034854600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL7256-7265 | OK | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Cedar Ridge at Broken Arrow | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | BROKEN ARROW, LLC | 38684 Upper Camp Creek Road, Springfield, OR 97477 |
| Street Address |
10107 S GARNETT RD |
| City | BROKEN ARROW |
| State | OK |
| Zip Code | 74011-1118 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861968992 | Seniorvision of Oklahoma LLC | Optometrist | 10107 S Garnett Rd, Broken Arrow, OK 74011-1118 | 2018-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336663699 | Cpii, LLC | Pharmacy | 811 W. New Orleans, Ste 101, Broken Arrow, OK 74011 | 2017-07-28 |
| 1053833608 | Cpii, LLC | Pharmacy | 811 W. New Orleans, Suite 101, Broken Arrow, OK 74011 | 2017-07-14 |
| 1184079709 | Melissa David | Lactation Consultant, Non-RN | 417 West San Diego St., Broken Arrow, OK 74011 | 2016-05-02 |
| 1154789576 | Rebecca Young | Registered Nurse | 7801 S Oak Pl, Broken Arrow, OK 74011 | 2016-01-29 |
| 1942524061 | Oklahoma Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 751 W Tuscan St, 121st, Broken Arrow, OK 74011 | 2010-03-18 |
| 1174764336 | Linda J. Russell | Counselor | 2446 W New Orleans St, Broken Arrow, OK 74011 | 2009-03-18 |
| 1851409080 | Kim Lee Mcneal | Dentist | 3764 South Elm Place, Broken Arrow, OK 74011 | 2006-08-28 |
| 1669433249 | Matthew E Ozment | Optometrist | 2500 West New Orleans, Broken Arrow, OK 74011 | 2006-03-31 |
| 1912275140 | Courtney Brooke Willcoxon | Pharmacist | 4704 S Elm Pl, Broken Arrow, OK 74011 | 2011-12-02 |
| 1558322883 | Gerald Seefeldt | Family Medicine | 66 Cedar Ridge Rd, Broken Arrow, OK 74011-1101 | 2006-03-28 |
| Find all providers in zip 74011 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740526474 | Forest Hills Alf LLC | Assisted Living Facility | 4304 W Houston St, Broken Arrow, OK 74012-4519 | 2012-12-28 |
| 1508032418 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 4001 S Aspen Ave, Broken Arrow, OK 74011-1465 | 2008-05-01 |
| 1740353689 | St.john Villas Inc | Assisted Living Facility | 17110 E 51st St, Broken Arrow, OK 74012-9279 | 2006-11-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834482 | Red Bud Assisted Living LLC | Assisted Living Facility | 215 W Freeman Ave, Perkins, OK 74059-5600 | 2020-09-03 |
| 1295371466 | Belfair of Mcalester LLC | Assisted Living Facility | 802 Windsong Way, Mcalester, OK 74501 | 2019-11-22 |
| 1396279808 | Teal Creek Life Care Community Inc | Assisted Living Facility | 13501 N. Bryant Ave., Edmond, OK 73013 | 2017-04-12 |
| 1568855278 | Remember When Assisted Living, LLC | Assisted Living Facility | 5729 Nw 82nd St, Oklahoma City, OK 73132-4909 | 2015-03-05 |
| 1306243019 | Green Country Rehabilitation | Assisted Living Facility | 3535 Nw 58th St Ste 940, Oklahoma City, OK 73112-4802 | 2014-11-24 |
| 1871908913 | Edmond Memory Care, LLC | Assisted Living Facility | 1001 S Bryant Ave, Edmond, OK 73034-5745 | 2014-06-27 |
| 1508270380 | Heatheridge Health Care, LLC | Assisted Living Facility | 2130 S 85th East Ave, Tulsa, OK 74129-3066 | 2014-06-19 |
| 1740608660 | United Senior Properties of Shawnee, LLC | Assisted Living Facility | 789 E Country Grove Dr, Shawnee, OK 74804-1404 | 2014-03-29 |
| 1730507658 | United Senior Properties of Seminole, LLC | Assisted Living Facility | 2207 West Wrangler Blvd, Seminole, OK 74868 | 2014-03-29 |
| 1962837039 | Hugo Family Pharmacy | Assisted Living Facility | 420 E Jackson St, Hugo, OK 74743-4021 | 2013-09-09 |
| Find all providers with the same taxonomy | ||||
| City | BROKEN ARROW |
| Zip Code | 74011 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.