Organization Active NPI

Tieszen Memorial Home Inc

  • Assisted Living Facility
  • Marion, SD
National Provider Identifier
1083693584
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
41974 Issued in SD
Legal business name
TIESZEN MEMORIAL HOME INC
Practice address
312 E State St
Marion, SD 57043-2011
Phone
(605) 648-3611
Fax
(605) 648-3363
NPI assigned
Jan 12, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Paul I Engbrecht
Title
Ceo
Phone
(605) 648-3611

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 41974 SD Primary
Skilled Nursing Facility 314000000X 10647 SD

Addresses

Primary practice location

312 E State St
Marion, SD 57043-2011

Mailing address

312 E State St
Marion, SD 57043-2011
Phone (605) 648-3611

Other identifiers 1

IdentifierTypeStateIssuer
0160650MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091124000669 SD Part A Provider - Skilled Nursing Facility 3173662590 Practice locations: Marion, SD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083693584. Details of each certification follow.

Skilled nursing facility certification: CCN 435069

Legal name
TIESZEN MEMORIAL HOME INC
Doing business as
AVEL ECARE, LLC
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jun 15, 1993
Last certification
Dec 19, 2024
Beds
64
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 26, 1945 in SD
Enrollment address
312 E State St
Marion, SD 57043-2011
Nursing home name
TIESZEN MEMORIAL HOME

Care Compare: Nursing home

Medicare Care Compare
Listed as
Tieszen Memorial HomeCCN 435069 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
2 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jun 15, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6458.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Tieszen Mem Home4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Paul Johnson Individual Corporate OfficerVice President Jan 20, 2020
Corporate DirectorVice President Nov 1, 2009
James a. Jones Individual Corporate DirectorMember Oct 27, 2009
Joseph Glendon Rees Individual Operational/Managerial Control Nov 15, 2021
Adp of the SNF Nov 15, 2021
Erin Patten Individual Corporate DirectorMember Jun 18, 2025
Richard Luke Individual Corporate OfficerSecretary Treasurer Jan 20, 2020
Corporate DirectorSecretary Treasurer Oct 27, 2009
Avel Ecare Medical Group, PC Organization, Sioux Falls, SD LLC Operational/Managerial Control Nov 15, 2021
Adp of the SNF Apr 1, 2026
Laura Wilson Individual Operational/Managerial Control Oct 27, 2009
Adp of the SNF May 29, 2020
Ravila Berens Individual Corporate OfficerPresident Jan 20, 2020
Corporate DirectorPresident Oct 27, 2009
Eric Tieszen Individual Corporate DirectorMember Feb 17, 2020
Deanna R Gall Individual Corporate DirectorMember Feb 1, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1083693584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 E STATE ST",
            "city": "MARION",
            "state": "SD",
            "postal_code": "570432011",
            "telephone_number": "605-648-3611",
            "fax_number": "605-648-3363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 E STATE ST",
            "city": "MARION",
            "state": "SD",
            "postal_code": "570432011",
            "telephone_number": "605-648-3611",
            "fax_number": "605-648-3363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIESZEN MEMORIAL HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ENGBRECHT",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "605-648-3611",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "SD",
            "license": "41974",
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "SD",
            "license": "10647",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160650",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, SD

Sources for this page

Verify at the official NPI Registry.