| Avera Mckennan Behavioral Health Services | |
|
4400 W 69th St Sioux Falls SD 57108-8170 | |
| (605) 322-8000 | |
| (605) 322-4009 |
| Full Name | Avera Mckennan Behavioral Health Services |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 4400 W 69th St, Sioux Falls, South Dakota |
| Authorized Official Name and Position | Ronald Joseph Place (PRESIDENT/CEO) |
| Authorized Official Contact | 6053227903 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avera Mckennan Behavioral Health Services 1325 S Cliff Ave Po Box 5045, Attn: P.f.s. Sioux Falls SD 57105-1007 Ph: (605) 322-8000 | Avera Mckennan Behavioral Health Services 4400 W 69th St Sioux Falls SD 57108-8170 Ph: (605) 322-8000 |
| NPI Number | 1164445250 |
|---|---|
| Provider Enumeration Date | 07/26/2006 |
| Last Update Date | 10/04/2023 |
| Certification Date | 10/04/2023 |
| Medicare PECOS PAC ID | 0345157103 |
|---|---|
| Medicare Enrollment ID | O20070129000151 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164445250 | NPI | - | NPPES |
| 8S016 | Other | SD | BLUE CROSS OF SD |
| 0230190 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 10563 (South Dakota) | Primary |
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