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General NPI Number Information
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NPI Number | 1407772932
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Entity Type | Organization
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Legal Business Name | OSAGE OPCO LLC
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Dates
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Enumeration Date | 06/29/2026
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Last Update Date | 07/02/2026
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Provider Practice Location Address
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Address Line | 830 S 5TH ST
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City | OSAGE
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State | IA
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Zip | 50461-1919
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Country | US
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Telephone | 641-732-5520
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Fax |
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Provider Business Mailing Address
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Address Line | 830 S 5TH ST
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City | OSAGE
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State | IA
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Zip | 50461-1919
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Country | US
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Telephone | 641-732-5520
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | BRANTLEY SHATTUCK
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Credential |
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Telephone | 208-206-0261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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