Entity Details

Basic

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

Medicaid #:
0801316

CCN #:
165232

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
050124

Initial License Date:
04/23/1983

Current License Date:
06/02/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
06/01/2024

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:
714 North Division Street

City:
Audubon

State:
Iowa

Zip:
50025-1300

Phone:
(712) 563-2651

Fax:
(712) 563-2342

URL:

Administrator/License #:
Jessica Andersen / 093513

Administrator Email:
jandersen@friendshiphome.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: