Organization
COVENANT CARE ENNOBLE, LLC
Active
Other names
Ennoble Skilled Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL SPARKS (DIRECTOR OF REIMBURSEMENT)
(949) 349-1200
Entity
Organization
Contact information
Practice address
2000 PASADENA DR, DUBUQUE, IA 52001-0808
(563) 577-1076
(563) 584-0671
Mailing address
2000 PASADENA DR, DUBUQUE, IA 52001-0808
(563) 577-1076
(563) 584-0671
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
310764
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0801183
—
IA
Enumeration date
06/17/2010
Last updated
06/17/2010
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