Organization
AVERA AT HOME
Active
Other names
Avera@Home
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA D DIELEMAN (CEO/PRESIDENT)
(605) 322-3984
Entity
Organization
Contact information
Practice address
4509 PRINCE OF PEACE PL, HOSPICE UNIT, SIOUX FALLS, SD 57103-5830
(605) 322-5490
(605) 322-3179
Mailing address
PO BOX 5045, SIOUX FALLS, SD 57117-5045
(605) 322-1872
(605) 322-1892
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
10563
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0929828
—
IA
01
—
1484AMC
BLUE CROSS OF MINNESOTA
MN
Enumeration date
07/24/2006
Last updated
06/30/2020
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