Entity Details

Basic

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

Former Entity Name:
Azria Rose Vista

Medicaid #:
0803510

CCN #:
165357

Occupancy Type:
Beds

Max Occupancy:
76

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
430306

Initial License Date:
09/06/2005

Current License Date:
04/01/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
04/01/2026

Months Since Last Survey:
5

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1109 Normal Street

City:
Woodbine

State:
Iowa

Zip:
51579-0006

Phone:
(712) 647-2010

Fax:
(402) 442-1315

URL:

Administrator/License #:
Kara Behrendt / 108043

Administrator Email:
Kbehrendt@azriahealth.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: