Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
54

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0330

Initial License Date:
09/21/2012

Current License Date:
09/22/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
09/22/2026

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:
2331 Nash Boulevard

City:
Council Bluffs

State:
Iowa

Zip:
51501

Phone:
(712) 242-5734

Fax:
(712) 256-4526

URL:

Administrator/License #:
Cassie Erwin /

Administrator Email:
cassie.erwin@hansenhouseliving.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: