Entity Details

Basic

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

Former Entity Name:
Rowley Masonic Home

Medicaid #:
0803544

CCN #:
165149

Occupancy Type:
Beds

Max Occupancy:
57

Status:
Closed

Close Date:
08/02/2020

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
250138

Initial License Date:
01/27/1989

Current License Date:

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:

Months Since Last Survey:
76

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1300 28th Street

City:
Perry

State:
Iowa

Zip:
50220-0578

Phone:
(515) 465-5316

Fax:
(515) 465-4869

URL:

Administrator/License #:
Melissa Gannon /

Administrator Email:
mgannon@perrylutheranhomes.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: