Entity Details

Basic

Entity Type:
Assisted Living Programs (ALP)

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
26

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0204

Initial License Date:
04/30/2004

Current License Date:
04/29/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
04/29/2026

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:
98 Bolger Drive

City:
Fayette

State:
Iowa

Zip:
52142-9716

Phone:
(563) 425-4160

Fax:
(563) 425-4401

URL:

Administrator/License #:
Angelique Vagts / Administrator

Administrator Email:
angeliquemarievagts89@gmail.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: