Entity Details

Basic

Entity Type:
Assisted Living Programs (ALP)

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
120

Status:
Closed

Close Date:
09/04/2009

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0267

Initial License Date:
01/10/2008

Current License Date:
01/20/2008

Renewal Cycle:
720

Entity Type Renewal Cycle(months):
24

Expiration Date:
01/09/2010

Months Since Last Survey:
218

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
45 West Jefferson St.

City:
North Liberty

State:
Iowa

Zip:
52317-9050

Phone:
(319) 626-3263

Fax:

URL:

Administrator/License #:
Victoria Huffman / Director

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: