Entity Details

Basic

Entity Type:
Assisted Living Programs (ALP)

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
28

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0420

Initial License Date:
11/18/2019

Current License Date:
11/18/2025

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
11/18/2027

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:
801 Benning Drive

City:
Holstein

State:
Iowa

Zip:
51025

Phone:
(712) 368-4893

Fax:
(712) 368-4949

URL:

Administrator/License #:
Tisha Kehler /

Administrator Email:
TKeleher@holsteinseniorliving.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: