Entity Details

Basic

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

Medicaid #:

CCN #:
165613

Occupancy Type:
Beds

Max Occupancy:
38

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
858462

Initial License Date:
09/01/2015

Current License Date:
10/28/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
10/28/2026

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:
3300 George Washington Carver Avenue

City:
Ames

State:
Iowa

Zip:
50010

Phone:
(515) 232-1000

Fax:
(515) 337-1903

URL:

Administrator/License #:
Kayla Zellmer / 089008

Administrator Email:
kayla.zellmer@northridgevillage.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: