Entity Details

Prairie Gate ( RCF )

Basic

Entity Type:
Residential Care Facilities (RCF)

Medicaid #:

CCN #:

Occupancy Type:
Beds

Max Occupancy:
36

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
786013

Initial License Date:
10/18/2023

Current License Date:
10/19/2025

Renewal Cycle:

Entity Type Renewal Cycle(months):
12

Expiration Date:
10/19/2026

Months Since Last Survey:
26

Entity Type Survey Cycle(months):
30

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
16 Valley View Dr

City:
Council Bluffs

State:
Iowa

Zip:
51503

Phone:
(712) 352-6600

Fax:

URL:

Administrator/License #:
Benjamin Eddy /

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

No Files Found

Licensure Rule Variance:

No Files Found