Entity Details

Basic

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

Former Entity Name:
Grand Living at Bridgewater ALP/D

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
64

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0375

Initial License Date:
06/11/2018

Current License Date:
06/11/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
06/11/2026

Months Since Last Survey:
5

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
3 Russell Slade Blvd.

City:
Coralville

State:
Iowa

Zip:
52241

Phone:
(319) 930-3000

Fax:
(319) 720-9553

URL:

Administrator/License #:
Dara Fishnick /

Administrator Email:
dfishnick@thesummitofcoralville.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: