Entity Details

Basic

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

Former Entity Name:
Imagine The Possibilities, Inc - Diamond Place

Medicaid #:
0881029

CCN #:
16G088

Occupancy Type:
Beds

Max Occupancy:
12

Status:
Closed

Close Date:
11/15/2021

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
620918

Initial License Date:

Current License Date:
04/25/2021

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
04/25/2022

Months Since Last Survey:
55

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1208 South 11th Street

City:
Oskaloosa

State:
Iowa

Zip:
52577-1092

Phone:
(641) 673-9447

Fax:
(641) 673-0195

URL:

Administrator/License #:
Kayla Woods /

Administrator Email:
kwoods@imagineia.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: