Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
36

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0415

Initial License Date:
09/09/2019

Current License Date:
09/10/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
09/10/2027

Months Since Last Survey:
7

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
2115 1st Avenue SE

City:
Cedar Rapids

State:
Iowa

Zip:
52402

Phone:
(319) 297-7072

Fax:
(319) 362-3987

URL:

Administrator/License #:
Melissa Holyoake /

Administrator Email:
mholyoake@cottagegroveplace.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: