Entity Details

Basic

Entity Type:
Assisted Living Programs (ALP)

Former Entity Name:
Lakeside Assisted Living

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
24

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0340

Initial License Date:
05/27/2014

Current License Date:
05/26/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
05/26/2026

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:
401 North Lawler Street

City:
Emmetsburg

State:
Iowa

Zip:
50536

Phone:
(712) 852-4060

Fax:
(712) 852-9914

URL:

Administrator/License #:
Gennifer Scott /

Administrator Email:
gscott@lakesidelutheranhome.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance:

File Name	Effective Date	Expiration Date	Rule Codes	File
LicensureRuleVariance_2925_2021-05-05_123324.pdf	03/25/2021