# THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
- **Other names:** Good Samaritan Society - Boise Village
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1053392548
- **Legal business name:** THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
- **Authorized official:** MS. RAYE NAE NYLANDER (CFO)
- **Authorized official phone:** (605) 362-3100

## Contact information

- **Practice address:** 129 E 50TH ST, GARDEN CITY, ID 83714-2407
- **Practice address phone:** (208) 333-2180
- **Mailing address:** PO BOX 5038, SIOUX FALLS, SD 57117-5038
- **Mailing address phone:** (605) 362-3100
- **Mailing address fax:** (605) 362-3265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |
| 332BN1400X | Nursing Facility Supplies (DME) | — | NULL | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | NULL | — |

## Other

- **Enumeration date:** 11/10/2005
- **Last updated:** 06/03/2024