Entity Details

Basic

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

Former Entity Name:
Promedica Skilled Nursing and Rehabilitation - Utica Ridge

Medicaid #:
0800020

CCN #:
165575

Occupancy Type:
Beds

Max Occupancy:
120

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
821080

Initial License Date:

Current License Date:
04/01/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
04/01/2026

Months Since Last Survey:
10

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
06/13/2024

Loss of NA Training Expires:
06/12/2026

Contact

Address:
3800 Commerce Blvd

City:
Davenport

State:
Iowa

Zip:
52807-3495

Phone:
(563) 344-2000

Fax:
(563) 344-9220

URL:

Administrator/License #:
Brandy Feller / 085595

Administrator Email:
brandy.feller@harmonyuticaridge.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: