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Organization
CONHOLD OF PONCA LLC
Active
Organization
CONHOLD OF PONCA LLC
Active
Other names
SHAWN MANOR NURSING HOME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES FRANK SULLIVAN (OWNER)
(918) 774-9696
Entity
Organization
Contact information
Practice address
2024 TURNER ST, PONCA CITY, OK 74604-2732
(580) 765-3364
(580) 765-3376
Mailing address
2024 TURNER ST, PONCA CITY, OK 74604-2732
(580) 765-3364
(580) 765-3376
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NH3607-3607
OK
Other
Enumeration date
03/10/2011
Last updated
03/21/2011
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