Healthcare Provider Details

I. General information

NPI: 1447100896
Provider Name (Legal Business Name): WESTRIDGE OPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 F AVE NW
CEDAR RAPIDS IA
52405-2946
US

IV. Provider business mailing address

3131 F AVE NW
CEDAR RAPIDS IA
52405-2946
US

V. Phone/Fax

Practice location:
  • Phone: 319-390-3367
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BRANTLEY SHATTUCK
Title or Position: MANAGING PARTNER
Credential:
Phone: 208-206-0261