Entity Details

Pride Group at 12th Street ( RCF )

Basic

Entity Type:
Residential Care Facilities (RCF)

Former Entity Name:
Pride Group @ 12th Street

Medicaid #:
0894485

CCN #:

Occupancy Type:
Beds

Max Occupancy:
8

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
750040

Initial License Date:
02/29/1988

Current License Date:
03/01/2026

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
03/01/2027

Months Since Last Survey:
3

Entity Type Survey Cycle(months):
30

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
200 12th Street SE

City:
Lemars

State:
Iowa

Zip:
51031-2503

Phone:
(712) 546-6570

Fax:
(712) 546-6589

URL:

Administrator/License #:
Jennifer Rohwer /

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

No Files Found

Licensure Rule Variance:

No Files Found