# 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 - Denton Village
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1891786174
- **Legal business name:** THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
- **Authorized official:** MR. JOEL FLUIT (VP, FINANCE)
- **Authorized official phone:** (605) 362-5416

## Contact information

- **Practice address:** 2500 HINKLE DR, DENTON, TX 76201-0739
- **Practice address phone:** (940) 383-2651
- **Practice address fax:** (940) 382-9306
- **Mailing address:** 4800 W 57TH ST, SIOUX FALLS, SD 57108-2239
- **Mailing address phone:** (605) 323-3453

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |
| 332BN1400X | Nursing Facility Supplies (DME) | — | — | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | — | — |

## Other

- **Enumeration date:** 11/04/2005
- **Last updated:** 09/02/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000509801 | — | TX |
| 01 | — | 0140910110 | MEDICARE NSC | TX |
| 01 | — | 455627 | MEDICARE OSCAR/CERTIFICATION | TX |