Avera Prince Of Peace

LBN: Avera Mckennan
Avera Prince Of Peace is an health care organization with primary practice located at 4513 S Prince Of Peace Pl , Sioux Falls SD 57103-5830. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Skilled Nursing Facility. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. Avera Mckennan can be contacted via phone (605) 322-5600, or through Place, Ronald Joseph via phone (605) 322-7903.

Contact Information

Primary practice address
4513 S Prince Of Peace Pl Sioux Falls SD 57103-5830
Phone: (605) 322-5600
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Place, Ronald Joseph Doctor of Medicine (MD)
Phone: (605) 322-7903

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 10722 South Dakota
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 10722 South Dakota

Profile Details

NPI number 1508854340
LBN Legal business name Avera Mckennan
DBA Doing business as Avera Prince Of Peace
Authorized official Place, Ronald Joseph Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 6th, 2005
Last updated Oct 4th, 2023 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508854340 NPPES
South Dakota MEDICAID 0151172
South Dakota MEDICAID 9572080
South Dakota Other 85066

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