Entity Details

Basic

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

Medicaid #:
0804088

CCN #:
165507

Occupancy Type:
Beds

Max Occupancy:
79

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
770333

Initial License Date:
08/26/1971

Current License Date:
08/24/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
08/24/2026

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:
2571 Guthrie Avenue

City:
Des Moines

State:
Iowa

Zip:
50317-3096

Phone:
(515) 265-2571

Fax:
(515) 265-3044

URL:

Administrator/License #:
Stephanie Proper / 085248

Administrator Email:
Stephanie.Proper@cassialife.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: