Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
51

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0054

Initial License Date:
07/13/1999

Current License Date:
10/23/2023

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
10/22/2025

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:
4040 E 55th St

City:
Davenport

State:
Iowa

Zip:
52807-2905

Phone:
(563) 322-0000

Fax:
(563) 441-0758

URL:

Administrator/License #:
Stephanie Smit /

Administrator Email:
stephanie.betourne@bickfordseniorliving.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: