Entity Details

Basic

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

Medicaid #:
0809509

CCN #:
165261

Occupancy Type:
Beds

Max Occupancy:
60

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
770477

Initial License Date:
01/01/2003

Current License Date:
01/02/2026

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
01/02/2027

Months Since Last Survey:
11

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1201 SE Mill Pond Court

City:
Ankeny

State:
Iowa

Zip:
50021-6595

Phone:
(515) 964-2273

Fax:
(515) 965-3100

URL:

Administrator/License #:
Jesica Culp / 131483

Administrator Email:
jculp@preshomes.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: