Organization
AVERA MCKENNAN
Active
Other names
AVERA ROSEBUD COUNTRY CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID WILLIAM FLICEK (CEO)
(605) 322-7915
Entity
Organization
Contact information
Practice address
126 S LOGAN AVE, GREGORY, SD 57533-1612
(605) 835-8296
(605) 835-9422
Mailing address
PO BOX 408, 400 PARK AVENUE, GREGORY, SD 57533-0408
(605) 835-8296
(605) 835-9422
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10625
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150070
—
SD
Enumeration date
07/02/2006
Last updated
02/10/2023
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