# 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 - Waukon
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1912115635
- **Legal business name:** THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
- **Authorized official:** MRS. RAYE NAE NYLANDER (VICE PRESIDENT, CFO)
- **Authorized official phone:** (605) 362-3100

## Contact information

- **Practice address:** 21 E MAIN ST, WAUKON, IA 52172-1748
- **Practice address phone:** (563) 568-3447
- **Practice address fax:** (563) 568-2459
- **Mailing address:** 4800 W 57TH ST, SIOUX FALLS, SD 57108-2239
- **Mailing address phone:** (605) 362-3100

## Taxonomy

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

## Other

- **Enumeration date:** 05/18/2007
- **Last updated:** 10/09/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0890137 | — | IA |