Entity Details

Basic

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

Medicaid #:
0880070

CCN #:
16G004

Occupancy Type:
Beds

Max Occupancy:
49

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
140734

Initial License Date:

Current License Date:
01/26/2026

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
01/26/2027

Months Since Last Survey:
8

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1211 East 18th Street

City:
Carroll

State:
Iowa

Zip:
51401-0887

Phone:
(712) 792-5500

Fax:
(712) 792-9944

URL:

Administrator/License #:
Lacie Tedrow /

Administrator Email:
Lacie_Tedrow@newhopevillage.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance:

File Name	Effective Date	Expiration Date	Rule Codes	File
LicensureRuleVariance_604_2025-11-04_095752.pdf	11/04/2025	05/01/2026	64.4(9)