# CONHOLD OF PONCA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SHAWN MANOR NURSING HOME
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124326434
- **Authorized official:** MR. JAMES FRANK SULLIVAN (OWNER)
- **Authorized official phone:** (918) 774-9696

## Contact information

- **Practice address:** 2024 TURNER ST, PONCA CITY, OK 74604-2732
- **Practice address phone:** (580) 765-3364
- **Practice address fax:** (580) 765-3376
- **Mailing address:** 2024 TURNER ST, PONCA CITY, OK 74604-2732
- **Mailing address phone:** (580) 765-3364
- **Mailing address fax:** (580) 765-3376

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH3607-3607 | OK | Yes |

## Other

- **Enumeration date:** 03/10/2011
- **Last updated:** 03/21/2011