Entity Details

Basic

Entity Type:
Residential Care Facilities (RCF)

Medicaid #:
0893735

CCN #:

Occupancy Type:
Beds

Max Occupancy:
43

Status:
Closed

Close Date:
11/02/2022

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
750562

Initial License Date:

Current License Date:
06/27/2022

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
06/27/2023

Months Since Last Survey:
54

Entity Type Survey Cycle(months):
30

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1240 Lincoln Street NE

City:
LeMars

State:
Iowa

Zip:
51031-3319

Phone:
(712) 546-6529

Fax:
(712) 546-6574

URL:

Administrator/License #:
Elissa Frederes /

Administrator Email:
Elissa.frederes@thepridegroup.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: