Entity Details

Basic

Entity Type:
Hospital-Licensed Only (HSP-Licensed Only)

Medicaid #:

CCN #:

Occupancy Type:

Max Occupancy:

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:

Initial License Date:
06/09/2025

Current License Date:
06/09/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
12

Expiration Date:
06/09/2027

Months Since Last Survey:

Entity Type Survey Cycle(months):
63

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
5406 Merle Hey Road

City:
Johnston

State:
Iowa

Zip:
50131

Phone:

Fax:

URL:

Provisional Administrator:
Teri Wehlig

Provisional Administrator Email:

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: