Entity Details

Basic

Entity Type:
Home Health Agencies (HHA)

Former Entity Name:
Universal Pediatrics

Medicaid #:

CCN #:
167249

Occupancy Type:

Max Occupancy:
0

Status:
Active

Close Date:

Accredited:
No Record Found

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:
84

Entity Type Survey Cycle(months):
36

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
3345 106th Cir

City:
Urbandale

State:
Iowa

Zip:
50322

Phone:
(515) 280-2180

Fax:
(515) 225-4433

URL:

Administrator/License #:
Kelsey Anderson /

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: