Entity Details

Basic

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

Medicaid #:
0805374

CCN #:
165158

Occupancy Type:
Beds

Max Occupancy:
70

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
730816

Initial License Date:

Current License Date:
09/17/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
09/17/2025

Months Since Last Survey:
10

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
01/09/2024

Loss of NA Training Expires:
01/08/2026

Contact

Address:
600 Manor Drive

City:
Clarinda

State:
Iowa

Zip:
51632-0475

Phone:
(712) 542-5161

Fax:
(402) 442-1315

URL:

Administrator/License #:
Sue Witthoft / 02080

Administrator Email:
switthoft@azriahealth.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: