Organization
AVERA QUEEN OF PEACE
Active
Parent organization
AVERA QUEEN OF PEACE
Other names
Avera Brady Assisted Living
Organization subpart
Yes
Provider details
NPI number
Legal business name
AVERA QUEEN OF PEACE
Authorized official
DOUGLAS EKEREN (PRESIDENT/CEO)
(605) 668-8322
Entity
Organization
Contact information
Practice address
1414 W CEDAR AVE, MITCHELL, SD 57301-3868
(605) 996-7702
Mailing address
525 N FOSTER ST, MITCHELL, SD 57301-2966
(605) 995-2000
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
41972
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9571240
—
SD
Enumeration date
06/16/2005
Last updated
08/20/2020
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