Entity Details

Basic

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

Former Entity Name:
Copper Shores Village Memory Care

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
28

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0239

Initial License Date:
06/26/2006

Current License Date:
06/26/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
06/26/2026

Months Since Last Survey:
14

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1500 Edgewater Drive

City:
Pleasant Hill

State:
Iowa

Zip:
50327-0921

Phone:
(515) 262-4444

Fax:
(515) 262-3840

URL:

Administrator/License #:
Tabitha Bleich /

Administrator Email:
tbleich@Immanuel.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: