Arkansas Elder Outreach of Little Rock, Inc.
Organization Active NPI Skilled Nursing Facility · Lockport, LA
NPI 1407933674 · NPPES record last updated May 7, 2021
Key facts
- NPI
- 1407933674
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 989 (LA)
- Legal business name
- ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC.
- Practice address
- 7534 Highway 1
Lockport, LA 70374-3437 - Phone
- (985) 532-1011
- Fax
- (985) 532-1015
- NPI assigned
- Nov 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Bonnie Quibodeaux
- Title
- Cfo
- Phone
- (225) 769-7960
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 4
Practitioners 2
-
Samer Bakhos, M.D.
-
Matthew Taylor, MD
Affiliated clinicians 1
-
Matthew Taylor, MD
Medicare Care Compare: Nursing home
- Listed as
- The Broadway Nursing and Rehabilitation Ctr
- Overall star rating
- ★★☆☆☆ 2 of 5
- Health inspections
- ★★★☆☆ 3 of 5
- Staffing
- ★★☆☆☆ 2 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- May 12, 2003
- Medicare certification status
- Active
- Certified beds
- 126 · 118.3 residents per day on average
- Chain
- Elder Outreach Nursing & Rehabilitation
- Penalties (3 years)
- 2 · fines totaling $29,126
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Skilled nursing facility certification: CCN 195583
- Legal name
- ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC.
- Doing business as
- THE BROADWAY ELDER LIVING & REHABILITATION
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- May 12, 2003
- Last certification
- May 14, 2025
- Beds
- 126
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Arkansas Elder Outreach at Little Rock
- Organization structure
- Corporation · Non-profit
- Incorporated
- Dec 26, 2002 in AR
- Enrollment address
- 7534 Hwy 1
The Broadway Elder Living & Rehabilitation
Lockport, LA 70374-3437 - Nursing home name
- THE BROADWAY NURSING AND REHABILITATION CTR
- Affiliated entity
- ELDER OUTREACH NURSING & REHABILITATION
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Todd Cole |
Corporate Director | Sep 16, 2015 | |
| W-2 Managing Employee | Jan 1, 2015 | ||
| Jude Sittig |
Corporate Director |
Feb 17, 2010 | 100% |
| Bonnie Quibodeaux |
Corporate Officer |
Jan 1, 2017 | |
| Cory Gatte |
Corporate Director | Nov 29, 2017 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100113000186 | LA | Part a Provider - Skilled Nursing Facility | 4880505858 | Practice locations: Lockport, LA |
National Provider Directory
- Tax ID family
- Arkansas Elder Outreach of Little Rock Inc
Locations
146 E 28th St
Cut Off, LA 70345
Phone (985) 414-4336
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 989 | LA | Yes |
Addresses
Primary practice location
7534 Highway 1
Lockport, LA 70374-3437
Mailing address
7534 Highway 1
Lockport, LA 70374-3437
Phone (985) 532-1011
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1515612 | Medicaid | LA |
Other names
- The Broadway Nursing and Rehabilitation Center
Other providers in Lockport, LA
- Adams Karam LLC
- Blaine Paul Adams
- Arcement-Baye Chiropractic Clinic, LLC
- Nicholas Joseph Arcement
- Kerra Lynn Arceneaux
- Samer Bakhos
- Bobbie N Morris DDS LLC
- Rewa Boone
- Joseph Bosworth
- Sidney Paul Bourg
All providers in Lockport, LA · Skilled Nursing Facility in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.