Entity Details

Basic

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

Medicaid #:
0803320

CCN #:
165574

Occupancy Type:
Beds

Max Occupancy:
55

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
710410

Initial License Date:

Current License Date:
10/25/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
10/25/2026

Months Since Last Survey:
9

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
610 N. Eastern Street

City:
Sanborn

State:
Iowa

Zip:
51248-0000

Phone:
(712) 930-3228

Fax:
(712) 729-5152

URL:

Administrator/License #:
Wendy Nelson / 02128

Administrator Email:
wnelson@tcaexpress.net

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: