NPI | 1386693430 |
---|---|
Doing Business As | AVERA MOTHER JOSEPH MANOR |
Entity Type | Organization |
Authorized Contact | RONALD L JACOBSON Chief Executive Officer 605-622-5125 |
Organization Subpart ? | No |
Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: SD 10590) |
Enumeration Date | 2006-05-08 |
Last Update Date | 2020-08-22 |