Entity Details

Basic

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

Medicaid #:
0809046

CCN #:
165252

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
270214

Initial License Date:

Current License Date:
10/01/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
10/01/2025

Months Since Last Survey:
4

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
203 SW Lorraine

City:
Leon

State:
Iowa

Zip:
50144-0140

Phone:
(641) 446-4165

Fax:
(641) 446-6604

URL:

Administrator/License #:
Rose Saxton / 072886

Administrator Email:
wvaccadmin@grm.net

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: