Entity Details

Basic

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

Medicaid #:
0804716

CCN #:
165326

Occupancy Type:
Beds

Max Occupancy:
48

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
260208

Initial License Date:

Current License Date:
08/15/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
08/15/2025

Months Since Last Survey:
7

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
800 North Davis Street

City:
Bloomfield

State:
Iowa

Zip:
52537-1107

Phone:
(641) 664-2699

Fax:
(641) 664-2929

URL:

Administrator/License #:
Nancy Newman / 002689

Administrator Email:
nnewman@bloomfieldcarecenter.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: