Entity Details

Basic

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

Medicaid #:
0805440

CCN #:
165399

Occupancy Type:
Beds

Max Occupancy:
101

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
910845

Initial License Date:

Current License Date:
09/15/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
09/14/2024

Months Since Last Survey:
12

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
04/17/2023

Loss of NA Training Expires:
04/16/2025

Contact

Address:
815 High Road

City:
Norwalk

State:
Iowa

Zip:
50211-0279

Phone:
(515) 981-4269

Fax:
(515) 981-5208

URL:

Administrator/License #:
Carla Hall / 02131

Administrator Email:
chall@mgmhealthcare.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: