Entity Details

Basic

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

Medicaid #:
0800599

CCN #:
165590

Occupancy Type:
Beds

Max Occupancy:
46

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
160149

Initial License Date:
04/27/1988

Current License Date:
03/06/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
03/06/2026

Months Since Last Survey:
7

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
402 Second Ave

City:
Clarence

State:
Iowa

Zip:
52216-0485

Phone:
(563) 452-3262

Fax:
(563) 452-3848

URL:

Administrator/License #:
Jason Tjaden / 02265

Administrator Email:
cnhcla@netins.net

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: