Healthcare Provider Details

I. General information

NPI: 1144396326
Provider Name (Legal Business Name): WEST RIDGE ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 12/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 F AVE NW
CEDAR RAPIDS IA
52405
US

IV. Provider business mailing address

3131 F AVE NW
CEDAR RAPIDS IA
52405
US

V. Phone/Fax

Practice location:
  • Phone: 319-390-3367
  • Fax: 319-390-3076
Mailing address:
  • Phone: 319-390-3367
  • Fax: 319-390-3076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number570097
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MR. TERRY S WARNER
Title or Position: PRESIDENT
Credential:
Phone: 319-390-3367