# 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 - Fairfield Glade
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1245539576
- **Legal business name:** THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
- **Authorized official:** RAYE NAE NYLANDER (EXECUTIVE VICE PRESIDENT)
- **Authorized official phone:** (605) 362-3100

## Contact information

- **Practice address:** 100 SAMARITAN WAY, CROSSVILLE, TN 38558
- **Practice address phone:** (931) 456-1576
- **Practice address fax:** (931) 456-1575
- **Mailing address:** 4800 W 57TH ST, SIOUX FALLS, SD 57108-2239

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/25/2011
- **Last updated:** 11/28/2021