Entity Details

Basic

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

Former Entity Name:
Risen Son Christian Village

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
26

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0200

Initial License Date:
11/12/2004

Current License Date:
11/13/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
11/13/2026

Months Since Last Survey:
2

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
3000 Risen Son Boulevard

City:
Council Bluffs

State:
Iowa

Zip:
51503-1191

Phone:
(712) 366-9655

Fax:
(712) 366-4748

URL:

Administrator/License #:
Dave Creal / 133051

Administrator Email:
dcreal@chapterscouncilbluffs.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: