Provider Contact Information
COUNTRY VILLA (Residential Care Apartment Complex)
1415 WEST MAIN STREET
LITTLE CHUTE, WI 54140

Directions? Map It

Contact Name: Shanta Jackson
Telephone Number: (920) 788-3444
Additional Provider Information
Licensure Status
REGULAR
License Number
0018625
Ownership Type
Corporation - Business
Owner Name
Country Villa Assisted Living in Omro Inc
Bed Capacity
53
Class
CERTIFIED
HCBS Compliance / Public Funding Status
Compliant
Survey History

• For more information on the survey history, consult the Division of Quality Assurance survey information web site.

Survey TypeExit DateEnforcementStatement of DeficiencyPlan of Correction
COMPLAINT11/15/2024
  •  
  •  
COMPLAINT07/16/2024
  •  
  •  
COMPLAINT02/29/2024
  •  
  •  
Additional Resources
Filing a Complaint against a Wisconsin Health or Residential Care Entity
Wisconsin Assisted Living Directories and Facility Profiles - Listed by county and by the type of assisted living provider type, then by facility name.
Guide to use when evaluating prospective facilities: Choosing an Assisted Living Facility (P-60579) (PDF, 124 KB)
Wisconsin Long Term Care and Support Services web page provides links to services and resources.
Alzheimer's Association:Choosing Health Care Providers and Facilities (exit DHS)
National Citizens' Coalition for Nursing Home Reform (NCCNHR) - Resources for Long-Term Care Consumers (exit DHS)