Entity Details

Basic

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

Medicaid #:
0800029

CCN #:
165555

Occupancy Type:
Beds

Max Occupancy:
50

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
250229

Initial License Date:

Current License Date:
11/01/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
11/01/2026

Months Since Last Survey:
10

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
10/16/2025

Loss of NA Training Expires:
10/16/2027

Contact

Address:
1919 Greene Street

City:
Adel

State:
Iowa

Zip:
50003-1636

Phone:
(515) 993-4511

Fax:
(515) 993-3951

URL:

Administrator/License #:
Kody Petrich / 088580

Administrator Email:
kpetrich@adelacres.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: