Entity Details

Basic

Entity Type:
Assisted Living Programs (ALP)

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
40

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0321

Initial License Date:
09/09/2011

Current License Date:
09/09/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
09/09/2027

Months Since Last Survey:
16

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
112 West 4th Street

City:
Boone

State:
Iowa

Zip:
50036

Phone:
(515) 432-1393

Fax:
(515) 432-7882

URL:

Administrator/License #:
Breanna Streeter /

Administrator Email:
bstreeter@efreechurchhome.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: