Entity Details

Basic

Entity Type:
Home Health Agencies (HHA)

Former Entity Name:
INNOVIVE HEALTH OF IOWA

Medicaid #:

CCN #:
167439

Occupancy Type:
Beds

Max Occupancy:

Status:
Active

Close Date:

Accredited:
Community Health Accreditation Partner

Accredited/Deemed:
Community Health Accreditation Partner

License & Survey

License #:

Initial License Date:

Current License Date:

Renewal Cycle:

Entity Type Renewal Cycle(months):
356

Expiration Date:

Months Since Last Survey:

Entity Type Survey Cycle(months):
36

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1415 28th ST, STE 240

City:
West Des Moines

State:
Iowa

Zip:
50266

Phone:
(319) 352-6400

Fax:

URL:

Administrator/License #:
Kelley Blackburn /

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: