Entity Details

Basic

Entity Type:
Free Standing NF/SNF (Free Standing NF/SNF)

Medicaid #:
0807941

CCN #:
165292

Occupancy Type:
Beds

Max Occupancy:
39

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
870328

Initial License Date:
08/01/1999

Current License Date:
08/01/2026

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
08/01/2027

Months Since Last Survey:
15

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1005 W Pearl Street

City:
Bedford

State:
Iowa

Zip:
50833-1276

Phone:
(712) 523-2161

Fax:
(712) 523-3219

URL:

Administrator/License #:
Amanda Cozad / 134279

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: