Entity Details

Basic

Entity Type:
Assisted Living Programs for People with Dementia (ALP/D)

Former Entity Name:
Apple Valley Al

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
118

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0166

Initial License Date:
12/23/2002

Current License Date:
12/23/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
12/23/2026

Months Since Last Survey:
6

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
405 27th Avenue South

City:
Clear Lake

State:
Iowa

Zip:
50428-4012

Phone:
(641) 357-7083

Fax:
(641) 357-1785

URL:

Administrator/License #:
Brenda Smith / Administrator

Administrator Email:
bsmith@applevalleyplaceclearlake.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: