Entity Details

Basic

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

Medicaid #:
0881128

CCN #:
16G100

Occupancy Type:
Beds

Max Occupancy:
6

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
070512

Initial License Date:
05/20/1994

Current License Date:
05/20/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
05/20/2025

Months Since Last Survey:
9

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1605 Theimer

City:
Cedar Falls

State:
Iowa

Zip:
50613-0000

Phone:
(319) 266-4203

Fax:

URL:

Administrator/License #:
Carolyn Repp /

Administrator Email:
carolynrepp@comprehesnivesystems.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: