Organization
AVERA AT HOME
Active
Other names
Avera@Home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA D DIELEMAN (CEO/PRESIDENT)
(605) 322-3984
Entity
Organization
Contact information
Practice address
1115 E 5TH AVE, MITCHELL, SD 57301-2917
(605) 995-2268
Mailing address
PO BOX 5045, SIOUX FALLS, SD 57117-5045
(650) 322-1872
(605) 322-1892
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9550320
—
SD
Enumeration date
03/14/2007
Last updated
07/01/2020
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