Entity Details

Basic

Entity Type:
Assisted Living Programs (ALP)

Former Entity Name:
Davenport Lutheran Al

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
34

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0033

Initial License Date:
01/17/2001

Current License Date:
01/17/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
01/17/2027

Months Since Last Survey:
10

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1128 W 53rd St

City:
Davenport

State:
Iowa

Zip:
52806-2435

Phone:
(563) 386-6933

Fax:
(563) 386-1056

URL:

Administrator/License #:
Linda Cagle / Administrator

Administrator Email:
l.cagle@lhaa-e.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: