Entity Details

Basic

Entity Type:
RCF 3-5 Bed ID/MI/DD/BI (RCF 3-5 Bed ID/MI/DD/BI)

Former Entity Name:
Neurorestorative - Iowa City

Medicaid #:

CCN #:

Occupancy Type:
Beds

Max Occupancy:
5

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
520023

Initial License Date:
02/06/2013

Current License Date:
02/07/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
02/06/2025

Months Since Last Survey:
10

Entity Type Survey Cycle(months):
30

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
4569 Jenn Lane

City:
Iowa City

State:
Iowa

Zip:
52240

Phone:
(319) 338-7587

Fax:
(319) 338-2411

URL:

Administrator/License #:
Nicole Grissom /

Administrator Email:
nicole.grissom@sevitahealth.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: