Entity Details

Basic

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

Medicaid #:
0805366

CCN #:
165188

Occupancy Type:
Beds

Max Occupancy:
65

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
610812

Initial License Date:

Current License Date:
09/17/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
09/16/2024

Months Since Last Survey:
15

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1015 West Summit

City:
Winterset

State:
Iowa

Zip:
50273-2209

Phone:
(515) 462-1711

Fax:
(402) 442-1315

URL:

Administrator/License #:
Autumn Davis / 115841

Administrator Email:
audavis@azriahealth.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: