NPIMap

Organization Active NPI

Arkansas Elder Outreach of Little Rock, Inc.

Doing business as The Broadway Nursing and Rehabilitation Center

  • Skilled Nursing Facility
  • Lockport, LA
National Provider Identifier
1407933674
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
989 Issued in LA
Legal business name
ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC.
Doing business as
The Broadway Nursing and Rehabilitation Center
Practice address
7534 Highway 1
Lockport, LA 70374-3437
Phone
(985) 532-1011
Fax
(985) 532-1015
NPI assigned
Nov 1, 2006
Last updated
May 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Authorized official

Name
Bonnie Quibodeaux
Title
Cfo
Phone
(225) 769-7960

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 989 LA Primary

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 names 1

  • The Broadway Nursing and Rehabilitation Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100113000186 LA Part A Provider - Skilled Nursing Facility 4880505858 Practice locations: Lockport, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1407933674. Details of each certification follow.

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
CorporationNon-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

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
The Broadway Nursing and Rehabilitation CtrCCN 195583 · All quality measures
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
ActiveFrom the Provider of Services file
Certified beds
126118.3 residents per day on average
Chain
Elder Outreach Nursing & Rehabilitation5 facilities in the chain
Penalties (3 years)
2Fines totaling $29,126

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Arkansas Elder Outreach of Little Rock Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 5

Organizations listed as members of this organization in the National Provider Directory.

Locations

146 E 28th St
Cut Off, LA 70345
Phone (985) 537-3569

7534 Highway 1
Lockport, LA 70374
Phone (985) 532-1011

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Todd Cole Individual Corporate Director Sep 16, 2015
W-2 Managing Employee Jan 1, 2015
Jude Sittig Individual Corporate DirectorExecutive Director Feb 17, 2010 100%
Bonnie Quibodeaux Individual Corporate OfficerCfo Jan 1, 2017
Cory Gatte Individual Corporate Director Nov 29, 2017

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1407933674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7534 HIGHWAY 1",
            "city": "LOCKPORT",
            "state": "LA",
            "postal_code": "703743437",
            "telephone_number": "985-532-1011",
            "fax_number": "985-532-1015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7534 HIGHWAY 1",
            "city": "LOCKPORT",
            "state": "LA",
            "postal_code": "703743437",
            "telephone_number": "985-532-1011",
            "fax_number": "985-532-1015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS ELDER OUTREACH OF LITTLE ROCK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "QUIBODEAUX",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "225-769-7960"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Broadway Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Broadway Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lockport, LA

Sources for this page

Verify at the official NPI Registry.