Healthcare Provider Details

I. General information

NPI: 1992621429
Provider Name (Legal Business Name): CEDAR FALLS OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1728 W 8TH ST
CEDAR FALLS IA
50613-2002
US

IV. Provider business mailing address

1728 W 8TH ST
CEDAR FALLS IA
50613-2002
US

V. Phone/Fax

Practice location:
  • Phone: 319-277-2437
  • Fax:
Mailing address:
  • Phone: 319-277-2437
  • 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