Entity Details

Basic

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

Former Entity Name:
Qhc Mitchellville, Llc

Medicaid #:
0806034

CCN #:
165264

Occupancy Type:
Beds

Max Occupancy:
65

Status:
Closed

Close Date:
11/19/2022

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
770919

Initial License Date:
08/01/1981

Current License Date:
05/01/2022

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
05/01/2023

Months Since Last Survey:
25

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
114 Carter Street SW

City:
Mitchellville

State:
Iowa

Zip:
50169-5000

Phone:
(515) 967-3726

Fax:
(515) 967-3728

URL:

Administrator/License #:
Leslie Walsh / 074465

Administrator Email:
lwalsh@qhcmcares.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: