Entity Details

Basic

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

Medicaid #:
0808295

CCN #:
165270

Occupancy Type:
Beds

Max Occupancy:
53

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
400069

Initial License Date:

Current License Date:
08/01/2026

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
08/01/2027

Months Since Last Survey:
3

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1200 Highway 175 East

City:
Stratford

State:
Iowa

Zip:
50249-0260

Phone:
(515) 612-1542

Fax:
(515) 838-2797

URL:

Administrator/License #:
Alexander Plummer / 128417

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: