Broken Arrow, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

AL7256-7265 Issued in OK

Legal business name

BROKEN ARROW, LLC

Doing business as

Cedar Ridge at Broken Arrow

Practice address

10107 S Garnett Rd
Broken Arrow, OK 74011-1118

Phone

(918) 461-1955

NPI assigned

Apr 22, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jon Harder

Title

Manager

Phone

(503) 485-4600

Specialties & licenses 1

Addresses

Other names 1

• Cedar Ridge at Broken Arrow Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063630671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 FAIRVIEW INDUSTRIAL DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973021177",
            "telephone_number": "503-485-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10107 S GARNETT RD",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740111118",
            "telephone_number": "918-461-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROKEN ARROW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-485-4600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OK",
            "license": "AL7256-7265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Ridge at Broken Arrow",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Broken Arrow Pediatric Behavioral Health LLC
• Broken Arrow Pediatrics, LLC
• Broken Arrow Public Schools
• Broken Arrow Rehabilitation Specialists
• Broken Arrow Womens Clinic Inc
• Brookdale Senior Living Communities, Inc. (Sterling House of Broken Arrow)
• Brooks Unlimited LLC (Tiger Talk Therapy Services)
• Damon Lee Brooks, D.O.
• John David Brooks III
• Parker Brooks

• Assisted Living Facility in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Assisted Living Facility in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.