Entity Details

Basic

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

Former Entity Name:
Prairie Hills at Des Moines Memory Care

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
54

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0299

Initial License Date:
10/15/2011

Current License Date:
10/15/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
10/15/2027

Months Since Last Survey:
20

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
5815 SE 27th Street

City:
Des Moines

State:
Iowa

Zip:
50320-9319

Phone:
(515) 256-9143

Fax:
(515) 287-2945

URL:

Administrator/License #:
Heather Johnson /

Administrator Email:
hjohnson@addingtonplaceofdesmoines.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: