Entity Details

Basic

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

Former Entity Name:
Opportunity Living III

Medicaid #:
0880872

CCN #:
16G074

Occupancy Type:
Beds

Max Occupancy:
20

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
130509

Initial License Date:
01/19/1993

Current License Date:
01/20/2026

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
01/20/2027

Months Since Last Survey:
12

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
612 Eighth Street

City:
Rockwell City

State:
Iowa

Zip:
50579

Phone:
(712) 464-8961

Fax:
(712) 464-3320

URL:

Administrator/License #:
Shannon Mahannah /

Administrator Email:
smahannah@opportunityliving.org

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: