Organization
AVERA ST LUKES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TESS MOELLER (EXEC VP)
(605) 622-2807
Entity
Organization
Contact information
Practice address
305 S STATE ST, ABERDEEN, SD 57401-4527
(605) 622-5000
(605) 622-5255
Mailing address
305 S STATE ST, ABERDEEN, SD 57401-4527
(605) 622-5000
(605) 622-5255
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
10525
SD
283Q00000X
Psychiatric Hospital
10525
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0230330
—
SD
05
—
0230332
—
SD
05
—
2381
—
ND
Enumeration date
05/15/2006
Last updated
07/15/2022
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