Entity Details

Basic

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

Medicaid #:
0807404

CCN #:
165346

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
120347

Initial License Date:
01/26/1996

Current License Date:
08/15/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
08/15/2025

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:
345 Parriott Street

City:
Aplington

State:
Iowa

Zip:
50604-1063

Phone:
(319) 347-2309

Fax:
(319) 347-6347

URL:

Administrator/License #:
Jordan Kampman / 120118

Administrator Email:
jkampman@legacyhc.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: