Entity Details

Basic

Entity Type:
Assisted Living Programs (ALP)

Former Entity Name:
Southcrest Manor II

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
32

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0221

Initial License Date:
11/16/2005

Current License Date:
11/16/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
11/16/2027

Months Since Last Survey:
6

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
602 2nd St SW

City:
Waukon

State:
Iowa

Zip:
52172-2242

Phone:
(563) 568-4207

Fax:
(563) 568-4209

URL:

Administrator/License #:
Jennifer Woods /

Administrator Email:
jwoods@southcrestmanorliving.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: