Entity Details

Basic

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

Former Entity Name:
Hallmark Care Center Mv

Medicaid #:
0804823

CCN #:
165333

Occupancy Type:
Beds

Max Occupancy:
55

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
570963

Initial License Date:

Current License Date:
08/15/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
08/15/2025

Months Since Last Survey:
4

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
215 Highway 30 West

City:
Mount Vernon

State:
Iowa

Zip:
52314-0000

Phone:
(319) 895-8891

Fax:
(319) 895-6703

URL:

Administrator/License #:
Jessica Vanderploeg / 079467

Administrator Email:
jvanderploeg@legacyhc.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: