Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
16

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S3016

Initial License Date:
12/15/2024

Current License Date:
12/15/2024

Renewal Cycle:

Entity Type Renewal Cycle(months):
24

Expiration Date:
12/15/2026

Months Since Last Survey:
10

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1010 North Elm Street

City:
Cresco

State:
Iowa

Zip:
52136

Phone:
(563) 547-2364

Fax:
(563) 547-5013

URL:

Administrator/License #:
Miranda Bruening /

Administrator Email:
mbruening@evansmemorialhome.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: