Entity Details

Basic

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

Medicaid #:

CCN #:
165605

Occupancy Type:
Beds

Max Occupancy:
40

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
770858

Initial License Date:
08/01/2011

Current License Date:
11/01/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
11/01/2026

Months Since Last Survey:
3

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
200 SW Brookside Drive

City:
Grimes

State:
Iowa

Zip:
50111

Phone:
(515) 369-3900

Fax:
(515) 369-3905

URL:

Administrator/License #:
Jayce Wilson / 108313

Administrator Email:
executivedirector@kbv-grimes.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: