Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Hospice Care, Community Based |
251G00000X | B4[14] | Hospice |
| NPI Number | 1467565325 |
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| LBN Legal business name | AVERA AT HOME | ||||
| Authorized official | SANDRA DIELEMAN - (CEO/PRESIDENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 08/16/2006 | ||||
| Last updated | 04/30/2021 - About 5 years ago | ||||
| Identifiers |
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