Entity Details

Basic

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

Medicaid #:
0801076

CCN #:
165468

Occupancy Type:
Beds

Max Occupancy:
76

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
080268

Initial License Date:
08/17/1983

Current License Date:
10/25/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
10/25/2025

Months Since Last Survey:
2

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
715 West Mamie Eisenhower

City:
Boone

State:
Iowa

Zip:
50036-4000

Phone:
(515) 432-5274

Fax:
(515) 432-5276

URL:

Administrator/License #:
Christina Walsh / 107200

Administrator Email:
cwalsh@iowaoeshome.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: