# THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
- **Other names:** St. Vincent's - a Prospera Community
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639274731
- **Legal business name:** THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
- **Authorized official:** ERIC VANDEN HULL (VICE PRESIDENT)
- **Authorized official phone:** (605) 362-5510

## Contact information

- **Practice address:** 1021 N 26TH ST, BISMARCK, ND 58501-3109
- **Practice address phone:** (701) 233-6888
- **Practice address fax:** (701) 223-3127
- **Mailing address:** 1021 N 26TH ST, BISMARCK, ND 58501-3109
- **Mailing address phone:** (701) 233-6888
- **Mailing address fax:** (701) 223-3127

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1005B | ND | Yes |

## Other

- **Enumeration date:** 09/13/2006
- **Last updated:** 11/28/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1005B | STATE | ND |
| 01 | — | 1347 | BCBS | — |
| 05 | — | 1469240 | — | ND |