Entity Details

Basic

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

Former Entity Name:
Brio Of Johnston, Llc

Medicaid #:

CCN #:
165624

Occupancy Type:
Beds

Max Occupancy:
36

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
775542

Initial License Date:
09/11/2018

Current License Date:
09/28/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
09/28/2026

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:
6901 Peckham Street

City:
Johnston

State:
Iowa

Zip:
50131

Phone:

Fax:

URL:

Administrator/License #:
Teresa Krueger / 002550

Administrator Email:
tkrueger@wesleylife.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: