Avera McKennan
Organization Active NPI Psychiatric Hospital Unit · Sioux Falls, SD
NPI 1225201205 · NPPES record last updated Oct 4, 2023
Key facts
- NPI
- 1225201205
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychiatric Hospital Unit 273R00000X
- License
- 10563 (SD)
- Legal business name
- AVERA MCKENNAN
- Practice address
- 4400 W 69TH St
Sioux Falls, SD 57108-8170 - Phone
- (605) 322-4000
- Fax
- (605) 322-4009
- NPI assigned
- Apr 10, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- AVERA MCKENNAN HOSPITAL AND UNIVERSITY HEALTH CENTER
Authorized official
- Name
- Ronald Joseph Place, MD
- Title
- President/Ceo
- Phone
- (605) 322-7903
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Avera McKennan Hosp
- Part of
- Avera McKennan Hosp
Locations
4400 W 69th St
Sioux Falls, SD 57108
Phone (605) 322-4005
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Hospital Unit | 273R00000X | 10563 | SD | Yes |
Addresses
Primary practice location
4400 W 69TH St
Sioux Falls, SD 57108-8170
Mailing address
4400 W 69TH St
Sioux Falls, SD 57108-8170
Phone (605) 322-4000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 475747502 | Medicaid | MN |
Other names
- Avera McKennan Behavioral Health Services
Other providers in Sioux Falls, SD
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- Avera McKennan
- Avera McKennan
- Avera McKennan
All providers in Sioux Falls, SD · Psychiatric Hospital Unit in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.