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
201 S. LLOYD STREET, STE 210 W,, ABERDEEN, SD 57401-4527
(605) 622-5200
(605) 622-5201
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
4069A
ND
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
59723
—
ND
Enumeration date
05/15/2006
Last updated
07/01/2020
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