Entity Details

Basic

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

Medicaid #:
0802181

CCN #:
165492

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
740436

Initial License Date:

Current License Date:
07/16/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
07/16/2026

Months Since Last Survey:
13

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
301 North Lawler Street

City:
Emmetsburg

State:
Iowa

Zip:
50536-1099

Phone:
(712) 852-4060

Fax:
(712) 852-9914

URL:

Administrator/License #:
Hallie Anderson / 128729

Administrator Email:
handerson@lakesidelutheranhome.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: