Entity Details

Basic

Entity Type:
Home Health Agencies (HHA)

Former Entity Name:
Universal Pediatrics

Medicaid #:

CCN #:
167321

Occupancy Type:

Max Occupancy:

Status:
Active

Close Date:

Accredited:
No Record Found

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:
108

Entity Type Survey Cycle(months):
36

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
702 Park Street

City:
Sheldon

State:
Iowa

Zip:
51201

Phone:
(712) 324-4012

Fax:
(712) 324-4091

URL:

Administrator/License #:
Mindy Van Beek / Administrator

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: