Entity Details

Basic

Entity Type:
Assisted Living Programs (ALP)

Former Entity Name:
Independence Village Of Pella AL

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
68

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0404

Initial License Date:
03/21/2019

Current License Date:
03/21/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
03/21/2027

Months Since Last Survey:
7

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
2604 Fifield Road

City:
Pella

State:
Iowa

Zip:
50219

Phone:
(641) 628-8260

Fax:
(641) 628-4259

URL:

Administrator/License #:
Lindsey Paxton /

Administrator Email:
lpaxton@independencevillages.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: