Entity Details

Basic

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

Medicaid #:
0801753

CCN #:
165483

Occupancy Type:
Beds

Max Occupancy:
54

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
920323

Initial License Date:
05/08/1961

Current License Date:
01/17/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
01/16/2025

Months Since Last Survey:
0

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1015 South Iowa Avenue

City:
Washington

State:
Iowa

Zip:
52353-1199

Phone:
(319) 653-8310

Fax:
(319) 653-8383

URL:

Administrator/License #:
Vani Tschantz / 081489

Administrator Email:
vtschantz@wesleylife.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: