Entity Details

Basic

Entity Type:
Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)

Former Entity Name:
Rem Iowa - Washington

Medicaid #:
0880559

CCN #:
16G039

Occupancy Type:
Beds

Max Occupancy:
8

Status:
Closed

Close Date:
08/29/2023

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
920609

Initial License Date:

Current License Date:
05/02/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
05/01/2024

Months Since Last Survey:
14

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1307 North Fifth Avenue

City:
Washington

State:
Iowa

Zip:
52353-2718

Phone:
(319) 683-7360

Fax:
(319) 545-1227

URL:

Administrator/License #:
Anne Sopousek /

Administrator Email:
anne.spousek@sevitahealth.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: