Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
118

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0397

Initial License Date:
11/08/2018

Current License Date:
11/08/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
11/08/2026

Months Since Last Survey:
25

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
703 Dye Street

City:
Harlan

State:
Iowa

Zip:
51537

Phone:
(833) 870-5182

Fax:
(833) 870-7145

URL:

Administrator/License #:
Mindy Shaffer /

Administrator Email:
director.harlan@hansenhouseliving.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: