Organization
AVERA MCKENNAN
Active
Other names
Avera Prince of Peace
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD JOSEPH PLACE MD (PRESIDENT/CEO)
(605) 322-7903
Entity
Organization
Contact information
Practice address
4513 S PRINCE OF PEACE PL, SIOUX FALLS, SD 57103-5830
(605) 322-5600
Mailing address
4500 S PRINCE OF PEACE PL, SIOUX FALLS, SD 57103-5830
(605) 322-5600
(605) 322-5622
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
10722
SD
314000000X
Skilled Nursing Facility
Primary
10722
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0151172
—
SD
01
—
85066
BLUE CROSS OF SD
SD
05
—
9572080
—
SD
Enumeration date
10/06/2005
Last updated
10/04/2023
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