Entity Details

Basic

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

Former Entity Name:
Maggie'S Place At Kennybrook Village

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
16

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0434

Initial License Date:
07/01/2020

Current License Date:
07/01/2026

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
06/30/2028

Months Since Last Survey:
12

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
230 SW Brookside Drive

City:
Grimes

State:
Iowa

Zip:
50111

Phone:
(515) 369-3900

Fax:
(515) 369-3905

URL:

Administrator/License #:
Jayce Wilson /

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: