Entity Details

Basic

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

Medicaid #:
0808824

CCN #:
165460

Occupancy Type:
Beds

Max Occupancy:
35

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
770275

Initial License Date:

Current License Date:
10/02/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
10/02/2026

Months Since Last Survey:
8

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
3605 Elm Drive

City:
Urbandale

State:
Iowa

Zip:
50322-0000

Phone:
(515) 276-4969

Fax:
(515) 309-0247

URL:

Administrator/License #:
Pam Harned / 077541

Administrator Email:
karenacres@hotmail.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: