# THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Victorian Legacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902948482
- **Authorized official:** MRS. RAYE NAE NYLANDER (VICE PRESIDENT, CFO)
- **Authorized official phone:** (605) 362-3100

## Contact information

- **Practice address:** 1160 SUNRISE ST, SUPERIOR, NE 68978-2344
- **Practice address phone:** (402) 879-3099
- **Practice address fax:** (402) 879-3445
- **Mailing address:** 4800 W 57TH ST, SIOUX FALLS, SD 57108-2239
- **Mailing address phone:** (605) 362-3100

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 10025321600 | — | NE |