Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
73

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0042

Initial License Date:
09/30/1999

Current License Date:
09/29/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
09/29/2026

Months Since Last Survey:
16

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
5915 Sutton Place

City:
Urbandale

State:
Iowa

Zip:
50322-1877

Phone:
(515) 331-3000

Fax:
(515) 270-1781

URL:

Administrator/License #:
Alex Millonig / Ex Director

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: