Entity Details

Basic

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

Medicaid #:

CCN #:

Occupancy Type:
Units

Max Occupancy:
64

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
S0273

Initial License Date:
06/04/2008

Current License Date:
06/03/2024

Renewal Cycle:
730

Entity Type Renewal Cycle(months):
24

Expiration Date:
06/03/2026

Months Since Last Survey:
23

Entity Type Survey Cycle(months):
24

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1801 East Kanesville Blvd.

City:
Council Bluffs

State:
Iowa

Zip:
51503

Phone:
(712) 352-1111

Fax:
(712) 352-0145

URL:

Administrator/License #:
Tiffany Eggett /

Administrator Email:
teggett@primroseretirement.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: