Entity Details

Basic

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

Medicaid #:
0807974

CCN #:
165225

Occupancy Type:
Beds

Max Occupancy:
67

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
040578

Initial License Date:

Current License Date:
08/01/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
07/31/2024

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:
1208 East Cross Street

City:
Centerville

State:
Iowa

Zip:
52544-3599

Phone:
(641) 856-8651

Fax:
(641) 856-6430

URL:

Administrator/License #:
Jason Van Der Veer / 02079

Administrator Email:
jvanderveer@careinitiatives.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: