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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