0001527532-15-000002.txt : 20150930 0001527532-15-000002.hdr.sgml : 20150930 20150930113804 ACCESSION NUMBER: 0001527532-15-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20150930 DATE AS OF CHANGE: 20150930 EFFECTIVENESS DATE: 20150930 FILER: COMPANY DATA: COMPANY CONFORMED NAME: PRAIRIE VIEW ASSISTED LIVING, LLC CENTRAL INDEX KEY: 0001527532 IRS NUMBER: 000000000 STATE OF INCORPORATION: NE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-248483 FILM NUMBER: 151133076 BUSINESS ADDRESS: STREET 1: 84225 533 AVENUE CITY: TILDEN STATE: NE ZIP: 68781 BUSINESS PHONE: 402-368-5967 MAIL ADDRESS: STREET 1: 84225 533 AVENUE CITY: TILDEN STATE: NE ZIP: 68781 D 1 primary_doc.xml X0707 D LIVE 0001527532 PRAIRIE VIEW ASSISTED LIVING, LLC 100 S. PINE ST. TILDEN NE NEBRASKA 68781 402-851-1668 NEBRASKA None None Limited Liability Company true 2011 LARRY TEGELER 100 S. PINE ST. TILDEN NE NEBRASKA 68781 Director MANAGER OF ISSUER CHARLIE QUALSET 100 S. PINE ST. TILDEN NE NEBRASKA 68781 Director MANAGER OF ISSUER RANDY KOSSMAN 100 S. PINE ST. TILDEN NE NEBRASKA 68781 Director MANAGER OF ISSUER JOHN LARSON 100 S. PINE ST. TILDEN NE NEBRASKA 68781 Director MANAGER OF ISSUER ARLENE HOFFMAN 100 S. PINE ST. TILDEN NE NEBRASKA 68781 Director MANAGER OF ISSUER CONNIE RUTJENS 100 S. PINE ST. TILDEN NE NEBRASKA 68781 Director MANAGER OF ISSUER LORI BOSSARD 100 S. PINE ST. TILDEN NE NEBRASKA 68781 Director MANAGER OF ISSUER Other Health Care Decline to Disclose 06b false 2015-09-24 false true false 5000 600000 430000 170000 false 15 0 0 0 false PRAIRIE VIEW ASSISTED LIVING, LLC JOHN LARSON JOHN LARSON MANAGER OF THE ISSUER 2015-09-30