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NPI Code Detail

MEDICARE: CEDAR FALLS OPCO LLC

MEDICARE: CEDAR FALLS OPCO LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1992621429
Entity Type Code : Organization
Provider Name (Legal Business Name) : CEDAR FALLS OPCO LLC
Provider Business Mailing Address
First Line : 1728 W 8TH ST
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-2002
Country : US
Telephone Number : 319-277-2437
Fax Number :
Provider Business Practice Location Address
First Line : 1728 W 8TH ST
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-2002
Country : US
Telephone Number : 319-277-2437
Fax Number :
Authorized Official
Title or Position : MANAGING PARTNER
Name : BRANTLEY SHATTUCK
Credential :
Telephone Number : 208-206-0261
Provider Enumeration Date : 06/29/2026
Last Update Date : 07/02/2026

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Directions to “CEDAR FALLS OPCO LLC ” Practice Location

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