Entity Details

Basic

Entity Type:
Home Health Agencies (HHA)

Medicaid #:

CCN #:
167328

Occupancy Type:

Max Occupancy:

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
Accreditation Commission for Health Care, Inc

License & Survey

License #:

Initial License Date:

Current License Date:

Renewal Cycle:

Entity Type Renewal Cycle(months):
356

Expiration Date:

Months Since Last Survey:

Entity Type Survey Cycle(months):
36

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1605 Associates Drive, Suite 103

City:
Dubuque

State:
Iowa

Zip:
52002-2270

Phone:
(563) 557-5762

Fax:

URL:

Administrator/License #:
Jayme LeJeune-Schomburg / Administrator

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: