Entity Details

Basic

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

Medicaid #:
0808113

CCN #:
165287

Occupancy Type:
Beds

Max Occupancy:
65

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
160589

Initial License Date:
07/01/1989

Current License Date:
08/01/2026

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
08/01/2027

Months Since Last Survey:
10

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
11/12/2025

Loss of NA Training Expires:
11/12/2027

Contact

Address:
451 West Orange Street

City:
West Branch

State:
Iowa

Zip:
52358-9701

Phone:
(319) 333-7182

Fax:
(319) 643-2139

URL:

Administrator/License #:
DeShaylea Pfannebecker / 135238

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: