Entity Details

Basic

Entity Type:
Home Health Agencies (HHA)

Former Entity Name:
Childserve Homecare, Inc.

Medicaid #:

CCN #:
167286

Occupancy Type:
Beds

Max Occupancy:
0

Status:
Active

Close Date:

Accredited:
Accreditation Commission for Health Care, Inc

Accredited/Deemed:
Accreditation Commission for Health Care, Inc

License & Survey

License #:

Initial License Date:

Current License Date:

Renewal Cycle:

Entity Type Renewal Cycle(months):
356

Expiration Date:

Months Since Last Survey:
24

Entity Type Survey Cycle(months):
36

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
5406 Merle Hay Rd

City:
Johnston

State:
Iowa

Zip:
50131

Phone:
(515) 727-8750

Fax:
(515) 727-8757

URL:

Administrator/License #:
Cody Campbell /

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: