Entity Details

Basic

Entity Type:
Free Standing NF/SNF (Free Standing NF/SNF)

Former Entity Name:
Pearl Valley Rehabilitation And Nursing At Gowrie, Llc

Medicaid #:
0809715

CCN #:
165344

Occupancy Type:
Beds

Max Occupancy:
19

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
940083

Initial License Date:
09/01/2001

Current License Date:
05/14/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
05/14/2026

Months Since Last Survey:
5

Entity Type Survey Cycle(months):
12

Special Focus Facility:
Yes

Special Focus Facility Survey Cycle(months):
6

Loss of NA Training Effective:
02/06/2024

Loss of NA Training Expires:
02/05/2026

Contact

Address:
1808 Main Street

City:
Gowrie

State:
Iowa

Zip:
50543-7438

Phone:
(515) 357-5817

Fax:
(515) 352-3989

URL:

Administrator/License #:
Angelia Mendez / 109675

Administrator Email:
ammendez@gowrieltc.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: