Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
80

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0427

Initial License Date:
01/31/2020

Current License Date:
01/31/2026

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
01/31/2028

Months Since Last Survey:
9

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
5710 Gibson Drive NE

City:
Cedar Rapids

State:
Iowa

Zip:
52411

Phone:
(319) 826-1094

Fax:
(319) 289-8037

URL:

Administrator/License #:
Stacy Koeppen /

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: