Department of Human Services

Facility

Facility Information

Mailing-Address:-Mailing address
Physical-Address:-Physcial Address
Phone-Number:-Phone
Fax-Number:-Fax

Administrator and Certifications

Administrator:-Administrator
Administrator-License-No:-Administrator License Number
Life-Safety-Code-Years:-Life Safety Code
Certification:-Certifications

Certified Beds

Homestyle-Beds:-0
Medicaid-Beds:-Medicaid Beds
Medicare-Beds:-Medicare Beds
Medicaid/Medicare-Beds:-Medicaid Medicare Beds
Private-Beds:-Private Beds
Classification:-Classification

Ownership and Financial Interest

Entity-Type:-Entity
Corporation-Name:-Corporation