| NPI | 1902559271 |
|---|---|
| Doing Business As | AVERA ADOLESCENT ADDICTION CENTER |
| Entity Type | Organization |
| Authorized Contact | DAVID WILLIAM FLICEK President/CEO 605-322-7915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2022-01-27 |