Entity Details

Basic

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

Medicaid #:
0804856

CCN #:
165343

Occupancy Type:
Beds

Max Occupancy:
77

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
810140

Initial License Date:
01/01/1985

Current License Date:
01/01/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
12/31/2024

Months Since Last Survey:
1

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
02/20/2023

Loss of NA Training Expires:
02/19/2025

Contact

Address:
601 Park Avenue

City:
Sac City

State:
Iowa

Zip:
50583-2429

Phone:
(712) 662-3818

Fax:
(712) 662-3393

URL:

Administrator/License #:
Kaylea Wibben / 091088

Administrator Email:
kwibben@abcmcorp.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: