Entity Details

Basic

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

Former Entity Name:
Rem Iowa- Birch Cottage

Medicaid #:
0880641

CCN #:
16G052

Occupancy Type:
Beds

Max Occupancy:
8

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
780451

Initial License Date:
05/01/2003

Current License Date:
05/02/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
05/02/2026

Months Since Last Survey:
11

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
29 East Street

City:
Shelby

State:
Iowa

Zip:
51570-0355

Phone:
(712) 544-2002

Fax:
(712) 544-2506

URL:

Administrator/License #:
Jill Anstey /

Administrator Email:
Jill.Anstey@sevitahealth.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: