Entity Details

Pride IV ( RCF )

Basic

Entity Type:
Residential Care Facilities (RCF)

Former Entity Name:
PRIDE IV

Medicaid #:

CCN #:

Occupancy Type:
Beds

Max Occupancy:
10

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
758071

Initial License Date:
10/03/2022

Current License Date:
10/04/2025

Renewal Cycle:

Entity Type Renewal Cycle(months):
12

Expiration Date:
10/04/2026

Months Since Last Survey:
11

Entity Type Survey Cycle(months):
30

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
248 14th Avenue NE

City:
LeMars

State:
Iowa

Zip:
51031

Phone:
(712) 541-6126

Fax:
(712) 546-6589

URL:

Administrator/License #:
Elissa Fredered /

Administrator Email:
[email protected]

Files

Life Safety Code (LSC) Waiver:

No Files Found

Licensure Rule Variance:

No Files Found