Entity Details

Basic

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

Former Entity Name:
Fort Dodge Health And Rehabilitation

Medicaid #:
0800010

CCN #:
165156

Occupancy Type:
Beds

Max Occupancy:
65

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
940900

Initial License Date:

Current License Date:
07/18/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
07/18/2026

Months Since Last Survey:
13

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
08/27/2025

Loss of NA Training Expires:
08/27/2027

Contact

Address:
728 14th Avenue North

City:
Fort Dodge

State:
Iowa

Zip:
50501-7016

Phone:
(515) 576-7226

Fax:
(515) 573-2865

URL:

Administrator/License #:
Daniel Dow / 126747

Administrator Email:
DDow@ensignservices.net

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: