Entity Details

Basic

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

Medicaid #:
0804690

CCN #:
165342

Occupancy Type:
Beds

Max Occupancy:
40

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
470995

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:
5

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
404 First Street

City:
Battle Creek

State:
Iowa

Zip:
51006-9425

Phone:
(712) 365-4332

Fax:
(712) 365-4855

URL:

Administrator/License #:
Todd Riessen / 002961

Administrator Email:
triessen@willowdalewellness.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: