Entity Details

Basic

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

Medicaid #:
0802025

CCN #:
165006

Occupancy Type:
Beds

Max Occupancy:
72

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
770384

Initial License Date:
05/18/1987

Current License Date:
05/18/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
05/18/2025

Months Since Last Survey:
1

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
900 Polk Boulevard

City:
Des Moines

State:
Iowa

Zip:
50312-2225

Phone:
(515) 255-5433

Fax:
(515) 277-8898

URL:

Administrator/License #:
Angela Meyer / 110373

Administrator Email:
ameyer@seniorlifecenter.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: