Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
28

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0384

Initial License Date:
08/23/2018

Current License Date:
08/22/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
08/22/2026

Months Since Last Survey:
19

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
5575 Pennsylvania Avenue

City:
Asbury

State:
Iowa

Zip:
52002

Phone:
(563) 583-6447

Fax:
(563) 583-5707

URL:

Administrator/License #:
Tracy Long /

Administrator Email:
tlong@hawkeyecare.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: