Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
79

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0078

Initial License Date:
05/04/2000

Current License Date:
05/04/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
05/04/2026

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:
205 Ehlers Lane

City:
Maquoketa

State:
Iowa

Zip:
52060-9615

Phone:
(563) 652-2125

Fax:
(563) 652-0145

URL:

Administrator/License #:
Jennifer Ingle /

Administrator Email:
jingle@cloverridgeplace.net

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: