Entity Details

Basic

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

Medicaid #:
0803122

CCN #:
165234

Occupancy Type:
Beds

Max Occupancy:
62

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
920820

Initial License Date:
06/28/1978

Current License Date:
11/01/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
11/01/2026

Months Since Last Survey:
6

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
516 13th Street

City:
Wellman

State:
Iowa

Zip:
52356-0000

Phone:
(319) 646-2911

Fax:
(319) 646-2443

URL:

Administrator/License #:
Kayleen Martin / 108967

Administrator Email:
kmartin@wellmanhc.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: