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NPI 1447100896

NPI 1447100896 : WESTRIDGE OPCO, LLC : CEDAR RAPIDS, IA

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General NPI Number Information
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    NPI Number           |    1447100896
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    Entity Type          |    Organization 
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    Legal Business Name  |    WESTRIDGE OPCO, LLC 
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Dates
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    Enumeration Date     |    02/03/2026
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    Last Update Date     |    02/03/2026
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Provider Practice Location Address
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    Address Line         |    3131 F AVE NW 
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    City                 |    CEDAR RAPIDS
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    State                |    IA
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    Zip                  |    52405-2946
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    Country              |    US
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    Telephone            |    319-390-3367
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3131 F AVE NW 
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    City                 |    CEDAR RAPIDS
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    State                |    IA
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    Zip                  |    52405-2946
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    Country              |    US
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    Telephone            |    
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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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