Avera Brady Assisted Living

LBN: Avera Queen Of Peace
Avera Brady Assisted Living is an health care organization with primary practice located at 1414 W Cedar Ave , Mitchell SD 57301-3868. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Assisted Living Facility, which is considered as the primary health care specialty. Avera Queen Of Peace can be contacted via phone (605) 996-7702, or through Ekeren, Douglas via phone (605) 668-8322.

Contact Information

Primary practice address
1414 W Cedar Ave Mitchell SD 57301-3868
Phone: (605) 996-7702
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ekeren, Douglas
Phone: (605) 668-8322

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 41972 South Dakota

Profile Details

NPI number 1497750384
LBN Legal business name Avera Queen Of Peace
DBA Doing business as Avera Brady Assisted Living
Authorized official Ekeren, Douglas
Entity Organization
Organization subpart 1 Yes
Enumeration date Jun 16th, 2005
Last updated Aug 20th, 2020 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497750384 NPPES
South Dakota MEDICAID 9571240

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