Entity Details

Basic

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

Former Entity Name:
University Park Nursing And Rehabilitation Center

Medicaid #:
0809889

CCN #:
165272

Occupancy Type:
Beds

Max Occupancy:
108

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
770502

Initial License Date:
06/01/2001

Current License Date:
03/01/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
03/01/2026

Months Since Last Survey:
23

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
233 University Avenue

City:
Des Moines

State:
Iowa

Zip:
50314-3124

Phone:
(515) 284-1280

Fax:
(515) 284-0127

URL:

Administrator/License #:
Stacy Soderstrum / 113527

Administrator Email:
ssoderstrum@universityparknursing.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: