Entity Details

Basic

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

Medicaid #:
0808071

CCN #:
165222

Occupancy Type:
Beds

Max Occupancy:
71

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
930336

Initial License Date:

Current License Date:
08/01/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
07/31/2024

Months Since Last Survey:
5

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
06/16/2022

Loss of NA Training Expires:
06/15/2024

Contact

Address:
745 East South

City:
Corydon

State:
Iowa

Zip:
50060-1830

Phone:
(641) 872-1590

Fax:
(641) 872-2623

URL:

Administrator/License #:
Jamiee Erickson / 110439

Administrator Email:
jerickson@careinitiatives.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: