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
826 N 8TH STREET, ESTHERVILLE, IA 51334-1528
(712) 362-2631
(712) 362-2636
Mailing address
PO BOX 5045, SIOUX FALLS, SD 57117-5045
(605) 322-1872
(605) 322-1892
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
320014H
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163550
—
IA
05
—
06271206
—
IA
05
—
0671206
—
IA
01
—
67120
WELLMARK HOME HEALTH
IA
Enumeration date
07/26/2006
Last updated
07/01/2020
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