Entity Details

Basic

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

Medicaid #:
0802686

CCN #:
165359

Occupancy Type:
Beds

Max Occupancy:
93

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
110001

Initial License Date:

Current License Date:
02/11/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
02/10/2025

Months Since Last Survey:
13

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1206 West Fourth Street

City:
Storm Lake

State:
Iowa

Zip:
50588-0000

Phone:
(712) 732-1120

Fax:
(712) 732-3406

URL:

Administrator/License #:
Nicholas Landgraf / 002646

Administrator Email:
nlandgraf@mmrcsl.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: