Entity Details

Basic

Entity Type:
Adult Day Services (ADS)

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
40

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
ADS111

Initial License Date:
03/07/2005

Current License Date:
03/06/2025

Renewal Cycle:
1095

Entity Type Renewal Cycle(months):
36

Expiration Date:
03/05/2028

Months Since Last Survey:
18

Entity Type Survey Cycle(months):
36

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
204 2nd Street SW

City:
Independence

State:
Iowa

Zip:
50644-2606

Phone:
(319) 334-2401

Fax:
(319) 334-4829

URL:

Administrator/License #:
Jaci Weber / Program Director

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: