Entity Details

Basic

Entity Type:
Rural Health Clinics (RHC)

Medicaid #:

CCN #:
168585

Occupancy Type:
Beds

Max Occupancy:

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
The Compliance Team

License & Survey

License #:

Initial License Date:

Current License Date:

Renewal Cycle:

Entity Type Renewal Cycle(months):
356

Expiration Date:

Months Since Last Survey:

Entity Type Survey Cycle(months):
73

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1314 South Stuart Street, Suite B

City:
Sigourney

State:
Iowa

Zip:
52591

Phone:
(641) 622-1170

Fax:

URL:

Administrator/License #:
Matthew Ives /

Administrator Email:
Matthew.Ives@keokukcountymedicalclinic.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: