Entity Details

Basic

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

Medicaid #:
807537

CCN #:
165238

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
240006

Initial License Date:

Current License Date:
02/01/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
01/31/2025

Months Since Last Survey:
12

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1202 Ridge Road

City:
Denison

State:
Iowa

Zip:
51442-0188

Phone:
(712) 263-5611

Fax:
(712) 639-6262

URL:

Administrator/License #:
Chandra Gustafson / 083494

Administrator Email:
Admin.Denison@trilliumhcg.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: