Healthcare Provider Details

I. General information

NPI: 1336953629
Provider Name (Legal Business Name): CHAPTERS COUNCIL BLUFFS OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 RISEN SON BLVD
COUNCIL BLUFFS IA
51503-1911
US

IV. Provider business mailing address

1734 GILSINN LN
FENTON MO
63026-2004
US

V. Phone/Fax

Practice location:
  • Phone: 712-366-9655
  • Fax:
Mailing address:
  • Phone: 314-440-2781
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: TYLER SCOTT BRADY
Title or Position: CFO
Credential:
Phone: 314-440-2781