Entity Details

Basic

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

Former Entity Name:
Country Meadow Place, Llc

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
89

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0004

Initial License Date:
11/03/1997

Current License Date:
06/01/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
06/01/2027

Months Since Last Survey:
13

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
17396 Kingbird Ave

City:
Mason City

State:
Iowa

Zip:
50401-9251

Phone:
(641) 423-7722

Fax:
(641) 421-7504

URL:

Administrator/License #:
John Joyner /

Administrator Email:
jjoyner@countrymeadowplace.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: