# 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 - Park River
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1669890653
- **Legal business name:** THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
- **Authorized official:** RAYE NAE NYLANDER (EXECUTIVE VP)
- **Authorized official phone:** (605) 362-3100

## Contact information

- **Practice address:** 301 COUNTY ROAD 12B, PARK RIVER, ND 58270-4134
- **Practice address phone:** (701) 284-7115
- **Mailing address:** PO BOX 5038, SIOUX FALLS, SD 57117-5038

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/07/2014
- **Last updated:** 04/07/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30788 | — | ND |