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
209 E BENTON ST, STE 110, ONEILL, NE 68763-1523
(402) 336-5296
(402) 336-5297
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
411001
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47046391105
—
NE
Enumeration date
06/15/2006
Last updated
07/01/2020
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