Entity Details

Basic

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

Former Entity Name:
Promedica Skilled Nursing and Rehabilitation - Dubuque

Medicaid #:
0800006

CCN #:
165104

Occupancy Type:
Beds

Max Occupancy:
89

Status:
Active

Close Date:

Accredited:
No Record Found

Accredited/Deemed:
No Record Found

License & Survey

License #:
310225

Initial License Date:
07/30/1983

Current License Date:
04/01/2024

Renewal Cycle:
365

Entity Type Renewal Cycle(months):
12

Expiration Date:
04/01/2025

Months Since Last Survey:
5

Entity Type Survey Cycle(months):
12

Special Focus Facility:
No

Loss of NA Training Effective:
05/03/2023

Loss of NA Training Expires:
05/02/2025

Contact

Address:
901 West Third Street

City:
Dubuque

State:
Iowa

Zip:
52001-6699

Phone:
(563) 556-1161

Fax:
(563) 583-1243

URL:

Administrator/License #:
Brandy Feller / 085595

Administrator Email:
bfeller@harmonydubuque.com

Files

Life Safety Code (LSC) Waiver:

Licensure Rule Variance: