Entity Details

Basic

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

Medicaid #:
0806596

CCN #:
165198

Occupancy Type:
Beds

Max Occupancy:
76

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
520052

Initial License Date:
04/01/1984

Current License Date:
02/01/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
02/01/2026

Months Since Last Survey:
1

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
3661 Rochester Avenue

City:
Iowa City

State:
Iowa

Zip:
52245-0000

Phone:
(319) 351-7460

Fax:
(319) 354-8428

URL:

Administrator/License #:
Tasha Stauffer / 079421

Administrator Email:
tstauffer@iowacityhc.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: