16D0648041 CLIA NUMBER - NEW HOPE VILLAGE

Laboratory Demographics

CLIA Number: 16D0648041

Facility Name: NEW HOPE VILLAGE

Facility Address:
1211 EAST 18TH STREET
CARROLL, IA
ZIP 51401
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Facility Phone Number: 712 792-5500

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1285729418

Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	16D0648041
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	NEW HOPE VILLAGE
Street	1211 EAST 18TH STREET
City	CARROLL
State	IA
ZIP	51401
Phone	712 792-5500
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024