Avera Prince Of Peace Outpatient Therapy
LBN: Avera Mckennan
Avera Prince Of Peace Outpatient Therapy is an health care organization with primary practice located at 4513 S Prince Of Peace Pl Ste 1 , Sioux Falls SD 57103-5830. The organization recently has only one registered license in Ambulatory Health Care Facilities / Multi-Specialty, which is considered as the primary health care specialty.
Avera Mckennan can be contacted via phone (605) 322-5618, or through Flicek, David via phone (605) 322-7915.
Contact Information
Primary practice address
4513 S Prince Of Peace Pl Ste 1
Sioux Falls SD 57103-5830
Phone: (605) 322-5618
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | 10563 | South Dakota |
Profile Details
| NPI number | 1467786640 |
|---|---|
| LBN Legal business name | Avera Mckennan |
| DBA Doing business as | Avera Prince Of Peace Outpatient Therapy |
| Authorized official | Flicek, David |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 22nd, 2009 |
| Last updated | Jul 1st, 2021 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467786640 | NPPES |
| Nebraska | MEDICAID | 10025846700 (OT GRP) | |
| Nebraska | MEDICAID | 10025846600 (PT ) | |
| Nebraska | MEDICAID | 1467786640 | |
| Nebraska | MEDICAID | 1467786640 | |
| Nebraska | Other | 9290262 |
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