Entity Details

Basic

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

Former Entity Name:
Ennoble Nursing and Rehabilitation

Medicaid #:
0801183

CCN #:
165559

Occupancy Type:
Beds

Max Occupancy:
85

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
310764

Initial License Date:
05/26/1977

Current License Date:
04/01/2025

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
04/01/2026

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:
2000 Pasadena Drive

City:
Dubuque

State:
Iowa

Zip:
52001-0808

Phone:
(563) 557-1076

Fax:
(563) 584-0671

URL:

Provisional Administrator:
Sheila Kintzle

Provisional Administrator Email:
administrator@ennoblenursing.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: