Entity Details

Basic

Entity Type:
Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)

Former Entity Name:
Pillar Of Cedar Valley - ICF/IID

Medicaid #:
0880278

CCN #:
16G051

Occupancy Type:
Beds

Max Occupancy:
53

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
070529

Initial License Date:

Current License Date:
01/20/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
01/19/2025

Months Since Last Survey:
13

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1410 West Dunkerton Road

City:
Waterloo

State:
Iowa

Zip:
50703-9626

Phone:
(319) 291-2509

Fax:
(319) 291-2570

URL:

Administrator/License #:
Hillary Arends / 107113

Administrator Email:
harends@pillarcv.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: