Entity Details

Basic

Entity Type:
Home Health Agencies (HHA)

Former Entity Name:
Iowa Home Care, Llc

Medicaid #:

CCN #:
167322

Occupancy Type:

Max Occupancy:

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:

Initial License Date:

Current License Date:

Renewal Cycle:

Entity Type Renewal Cycle(months):
356

Expiration Date:

Months Since Last Survey:
14

Entity Type Survey Cycle(months):
36

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
13133 Angle Road

City:
Ottumwa

State:
Iowa

Zip:
52501

Phone:
(641) 226-5050

Fax:
(641) 226-5699

URL:

Administrator/License #:
Molli Ruble / Administrator

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: