Entity Details

Basic

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

Former Entity Name:
Edencrest at Green Meadows

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
128

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0355

Initial License Date:
01/15/2016

Current License Date:
01/15/2026

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
01/15/2028

Months Since Last Survey:
8

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
6750 Corporate Drive

City:
Johnston

State:
Iowa

Zip:
50131

Phone:
(515) 207-1984

Fax:
(515) 777-2380

URL:

Administrator/License #:
Dwala Lehman / 077169

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: