Entity Details

Basic

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

Medicaid #:
0801944

CCN #:
165266

Occupancy Type:
Beds

Max Occupancy:
78

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
970145

Initial License Date:

Current License Date:
12/31/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
12/30/2024

Months Since Last Survey:
13

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1701 West 25th Street

City:
Sioux City

State:
Iowa

Zip:
51103

Phone:
(712) 252-2726

Fax:
(712) 293-1953

URL:
http:www.holyspiritretirementhome.com

Administrator/License #:
Kyla Louise Sprakel / 095988

Administrator Email:
kylas@holyspiritretirementhome.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: