Entity Details

Basic

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

Medicaid #:
0804765

CCN #:
165364

Occupancy Type:
Beds

Max Occupancy:
66

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
410334

Initial License Date:
10/07/1963

Current License Date:
10/05/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
10/04/2024

Months Since Last Survey:
9

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
490 West Lyon Street

City:
Garner

State:
Iowa

Zip:
50438-1906

Phone:
(641) 923-2677

Fax:
(641) 923-0074

URL:

Administrator/License #:
Jamie Harkema / 074777

Administrator Email:
jharkema@abcmcorp.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: