Entity Details

Basic

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

Former Entity Name:
Gardens Memory Support Al

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
32

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0198

Initial License Date:
10/22/2004

Current License Date:
10/22/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
10/22/2026

Months Since Last Survey:
7

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
420 Kenyon Road

City:
Fort Dodge

State:
Iowa

Zip:
50501-5749

Phone:
(515) 573-2121

Fax:
(515) 573-6077

URL:

Administrator/License #:
Cari Conrad /

Administrator Email:
cari.conrad@friendshiphaven.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: