Organization
AVERA MCKENNAN
Active
Organization
AVERA MCKENNAN
Active
Other names
Avera McKennan Behavioral Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD JOSEPH PLACE MD (PRESIDENT/CEO)
(605) 322-7903
Entity
Organization
Contact information
Practice address
4400 W 69TH ST, SIOUX FALLS, SD 57108-8170
(605) 322-8000
(605) 322-4009
Mailing address
1325 S CLIFF AVE, PO BOX 5045, ATTN: P.F.S., SIOUX FALLS, SD 57105-1007
(605) 322-8000
(605) 322-6499
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
10563
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0230190
—
SD
01
—
8S016
BLUE CROSS OF SD
SD
Enumeration date
07/26/2006
Last updated
10/04/2023
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