Entity Details

Basic

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

Medicaid #:
0808279

CCN #:
165251

Occupancy Type:
Beds

Max Occupancy:
176

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
070583

Initial License Date:

Current License Date:
08/01/2026

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
08/01/2027

Months Since Last Survey:
11

Entity Type Survey Cycle(months):
12

Special Focus Facility:
Yes

Special Focus Facility Survey Cycle(months):
6

Loss of NA Training Effective:
08/03/2026

Loss of NA Training Expires:
08/03/2028

Contact

Address:
2651 St Francis Drive

City:
Waterloo

State:
Iowa

Zip:
50702-5422

Phone:
(319) 232-6808

Fax:
(319) 232-4402

URL:

Administrator/License #:
Hilary Arends / 107113

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: