Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
21

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0057

Initial License Date:
08/24/2003

Current License Date:
08/24/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
08/24/2027

Months Since Last Survey:
19

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
4210 Hickman Rd

City:
Des Moines

State:
Iowa

Zip:
50310-3333

Phone:
(515) 277-6141

Fax:
(515) 271-0933

URL:

Administrator/License #:
Jeanette Perdue /

Administrator Email:
Jeanette@calvincommunity.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: