Entity Details

Basic

Entity Type:
Residential Care Facilities (RCF)

Medicaid #:
0893800

CCN #:

Occupancy Type:
Beds

Max Occupancy:
13

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
330278

Initial License Date:
07/30/1986

Current License Date:
07/31/2023

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
07/30/2024

Months Since Last Survey:
36

Entity Type Survey Cycle(months):
30

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
18569 Lane Road

City:
Fayette

State:
Iowa

Zip:
52142-9525

Phone:
(563) 422-5606

Fax:
(563) 422-5607

URL:

Administrator/License #:
Laura Peyton /

Administrator Email:
administrator@inspiringlivesiowa.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: