Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
20

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0090

Initial License Date:
07/19/2000

Current License Date:
07/18/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
07/18/2026

Months Since Last Survey:
4

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1320 Litchfield Dr

City:
Hiawatha

State:
Iowa

Zip:
52233-2343

Phone:
(319) 743-9812

Fax:
(319) 743-9815

URL:

Administrator/License #:
Marla Kaufman / Administrator

Administrator Email:
mkaufman@hiawathacarecenter.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: