Entity Details

Basic

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

Medicaid #:
0800565

CCN #:
165019

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
340392

Initial License Date:
05/30/1976

Current License Date:
05/01/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
05/01/2026

Months Since Last Survey:
7

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
602 11th Street

City:
Charles City

State:
Iowa

Zip:
50616-3403

Phone:
(641) 228-2353

Fax:
(641) 228-5264

URL:

Administrator/License #:
Misty Hobert / 094240

Administrator Email:
11thSt.Chaut2@gmail.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: