Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
18

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0168

Initial License Date:
02/07/2003

Current License Date:
02/07/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
02/07/2027

Months Since Last Survey:
22

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
512 13th Street

City:
Wellman

State:
Iowa

Zip:
52356-9327

Phone:
(319) 646-5812

Fax:
(319) 646-2443

URL:

Administrator/License #:
Paige Karr /

Administrator Email:
pkarr@mgmhealthcare.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: