AVERA MCKENNAN NPI 1053556068

NPI Information

  • NPI: 1053556068
  • Provider Name: AVERA MCKENNAN
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: AVERA PRINCE OF PEACE ASSISTED LIVING
  • Address: 4504 S PRINCE OF PEACE PL
    SIOUX FALLS, SD
    ZIP 57103
  • Phone: (605) 322-5600

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NPI Details

AVERA MCKENNAN is an assisted living facility in Sioux Falls, SD. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. AVERA MCKENNAN NPI is 1053556068. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Prince Of Peace Assisted Living.

The provider's business location address is:

4504 S PRINCE OF PEACE PL
SIOUX FALLS, SD
ZIP 57103-865
Phone: (605) 322-5600

The provider's authorized official is Ronald J. Place .
The authorized official title is President/ceo and has the following contact phone number (605) 322-7903.

The enumeration date for this NPI number is 12/4/2008 and was last updated on 9/14/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility46761SOUTH DAKOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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