Entity Details

Basic

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

Former Entity Name:
Timber City Wellness Center and Rehabilitation

Medicaid #:
0806406

CCN #:
165516

Occupancy Type:
Beds

Max Occupancy:
75

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
490974

Initial License Date:

Current License Date:
04/01/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
04/01/2025

Months Since Last Survey:
8

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:

Loss of NA Training Expires:

Contact

Address:
1015 Wesley Drive

City:
Maquoketa

State:
Iowa

Zip:
52060-0000

Phone:
(563) 652-4968

Fax:
(563) 652-3150

URL:

Administrator/License #:
Amanda Carr / 099167

Administrator Email:
acarr@jacksonridgehc.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: