Entity Details

Petersen Commons ( ALP )

Basic

Entity Type:
Assisted Living Programs (ALP)

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
102

Status:
Closed

Close Date:
12/15/2021

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0214

Initial License Date:
07/08/2005

Current License Date:
07/07/2021

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
07/07/2023

Months Since Last Survey:
85

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1607 West 12th Street

City:
Davenport

State:
Iowa

Zip:
52804-4086

Phone:
(563) 323-3888

Fax:
(563) 324-1373

URL:

Administrator/License #:
Kathleen Patrick /

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

No Files Found

Licensure Rule Variance:

No Files Found