Organization
AVERA ST LUKES
Active
Other names
Avera Mother Joseph Manor
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD L JACOBSON (CHIEF EXECUTIVE OFFICER)
(605) 622-5125
Entity
Organization
Contact information
Practice address
1002 N JAY ST, ABERDEEN, SD 57401-2439
(605) 622-5000
(605) 622-5255
Mailing address
1002 N JAY ST, ABERDEEN, SD 57401-2439
(605) 622-5000
(605) 622-5255
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10590
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151162
—
SD
Enumeration date
05/08/2006
Last updated
08/22/2020
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