Entity Details

Basic

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

Former Entity Name:
Rem Iowa - 33rd Avenue

Medicaid #:
0880045

CCN #:
16G190

Occupancy Type:
Beds

Max Occupancy:
8

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
578420

Initial License Date:
12/16/2020

Current License Date:
12/18/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
12/18/2026

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:
2620 33rd Avenue SW

City:
Cedar Rapids

State:
Iowa

Zip:
52403

Phone:
(319) 393-1944

Fax:

URL:

Administrator/License #:
Emily Naniot /

Administrator Email:
Emily.Naniot@sevitahealth.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: