Entity Details

Basic

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

Medicaid #:
0808048

CCN #:
165329

Occupancy Type:
Beds

Max Occupancy:
43

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
750184

Initial License Date:

Current License Date:
08/01/2026

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
08/01/2027

Months Since Last Survey:
14

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
05/21/2026

Loss of NA Training Expires:
05/21/2028

Contact

Address:
305 W 3rd Street

City:
Kingsley

State:
Iowa

Zip:
51028-0407

Phone:
(712) 378-2400

Fax:
(712) 378-2400

URL:

Administrator/License #:
Evangelina Klein / 133630

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: