Entity Details

Basic

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

Medicaid #:
0809343

CCN #:
165203

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Closed

Close Date:
11/02/2022

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
430203

Initial License Date:

Current License Date:
09/01/2022

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
09/01/2023

Months Since Last Survey:
21

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
314 South Elm Street

City:
Logan

State:
Iowa

Zip:
51546-0008

Phone:
(712) 644-2922

Fax:
(712) 644-3509

URL:

Administrator/License #:
Douglas Williams / 095617

Administrator Email:
douglas.williams@westmontcare.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: