Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
166

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0107

Initial License Date:
01/23/2001

Current License Date:
01/24/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
01/24/2027

Months Since Last Survey:
11

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
312 Southbrooke Dr

City:
Waterloo

State:
Iowa

Zip:
50702-5804

Phone:
(319) 291-1300

Fax:
(319) 291-1360

URL:

Administrator/License #:
Ema Baltic /

Administrator Email:
ebaltic@fvrc.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: