Entity Details

Basic

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

Former Entity Name:
Independence Village Of Ankeny MC

Medicaid #:

CCN #:

Occupancy Type:
Beds

Max Occupancy:
20

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0326

Initial License Date:
01/19/2012

Current License Date:
01/19/2026

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
01/19/2028

Months Since Last Survey:
23

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1275 SW State Street

City:
Ankeny

State:
Iowa

Zip:
50023

Phone:
(515) 963-4000

Fax:
(515) 639-2130

URL:

Administrator/License #:
Sydney Petersen /

Administrator Email:
sydney.petersen@independencevillages.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: