Entity Details

Basic

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

Medicaid #:
0802405

CCN #:
165371

Occupancy Type:
Beds

Max Occupancy:
40

Status:
Closed

Close Date:
07/30/2021

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
240486

Initial License Date:
04/19/1976

Current License Date:

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:

Months Since Last Survey:
72

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
146 North Fifth Street

City:
Manilla

State:
Iowa

Zip:
51454-0490

Phone:
(712) 654-6812

Fax:
(712) 654-6800

URL:

Administrator/License #:
Dawn Berrier /

Administrator Email:
dberrier@fmctc.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: