Entity Details

Basic

Entity Type:
Assisted Living Programs (ALP)

Former Entity Name:
Independence Village Of Waukee AL

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
80

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0257

Initial License Date:
04/10/2007

Current License Date:
04/10/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
04/10/2027

Months Since Last Survey:
18

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1654 SE Holiday Crest Circle

City:
Waukee

State:
Iowa

Zip:
50263-8685

Phone:
(515) 987-4100

Fax:
(515) 987-7093

URL:

Administrator/License #:
Austin Williams /

Administrator Email:
austin.williams@independencevillages.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: