# SAGE BRADBURY COMMONS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BRADBURY COMMONS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780562835
- **Authorized official:** MRS. KIMBERLY D GREEN (CEO)
- **Authorized official phone:** (918) 812-6968

## Contact information

- **Practice address:** 1601 ACADEMY RD, PONCA CITY, OK 74604-4409
- **Practice address phone:** (580) 370-7132
- **Mailing address:** 1601 ACADEMY RD, PONCA CITY, OK 74604-4409
- **Mailing address phone:** (580) 370-7132
- **Mailing address fax:** (918) 812-6968

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | — | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 08/26/2025
- **Last updated:** 08/26/2025