Entity Details

Basic

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

Medicaid #:
0801803

CCN #:
165177

Occupancy Type:
Beds

Max Occupancy:
62

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
710779

Initial License Date:
08/31/1992

Current License Date:
08/01/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
08/01/2026

Months Since Last Survey:
6

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
231 North Eighth Avenue West

City:
Hartley

State:
Iowa

Zip:
51346-0188

Phone:
(712) 728-2428

Fax:
(712) 728-2429

URL:

Administrator/License #:
Steven Ziller / 114130

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: