Entity Details

Basic

Entity Type:
Assisted Living Programs (ALP)

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
20

Status:
Closed

Close Date:
05/30/2019

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0174

Initial License Date:
05/30/2003

Current License Date:
05/29/2020

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
24

Expiration Date:
05/29/2021

Months Since Last Survey:
106

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
302 Franklin

City:
Keosauqua

State:
Iowa

Zip:
52565-1165

Phone:
(319) 293-3171

Fax:
(319) 293-6417

URL:

Administrator/License #:
Julie Ludwig / RN

Administrator Email:
[email protected]; [email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: