Healthcare Provider Details

I. General information

NPI: 1932085685
Provider Name (Legal Business Name): CRESTVIEW OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2025
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 DES MOINES ST
WEBSTER CITY IA
50595-3046
US

IV. Provider business mailing address

2833 SMITH AVE STE 144
BALTIMORE MD
21209-1426
US

V. Phone/Fax

Practice location:
  • Phone: 515-832-2727
  • Fax:
Mailing address:
  • Phone: 443-742-8167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DAVID INSEL
Title or Position: CEO
Credential:
Phone: 443-742-8167