Organization · Type 2 NPI

Avera Queen of Peace

Assisted Living Facility · Mitchell, SD

NPI number 1497750384 Active

Practice location

1414 W Cedar Ave
Mitchell, SD 57301-3868

Call (605) 996-7702 Map

Mailing address

525 N Foster St
Mitchell, SD 57301-2966

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	41972 (SD)

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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NPI record

NPI: 1497750384
Entity type: Organization (Type 2)
Issued: Jun 16, 2005
Last updated: Aug 20, 2020
Status: Active
Subpart: Yes of Avera Queen of Peace

Other names

<unavail>
Avera Brady Assisted Living · doing business as
Avera Brady Assisted Living · doing business as

Authorized official

Douglas Ekeren
President/ceo
(605) 668-8322

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1497750384

Avera Queen of Peace's National Provider Identifier is 1497750384, issued on Jun 16, 2005. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Mitchell, SD. The record was last updated on Aug 20, 2020.