Organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Active
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Other names
Sunset Drive - a Prospera Community
Organization subpart
Yes
Provider details
NPI number
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Authorized official
ERIC VANDEN HULL (VICE PRESIDENT)
(605) 362-5510
Entity
Organization
Contact information
Practice address
1011 BOUNDARY ST NW, MANDAN, ND 58554-1608
(701) 323-1411
(701) 323-1395
Mailing address
1011 BOUNDARY ST NW, MANDAN, ND 58554-1608
(701) 323-1411
(701) 323-1395
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1092A
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1092A
STATE
ND
05
—
1469246
—
ND
01
—
4820
BCBS
ND
Enumeration date
09/13/2006
Last updated
11/28/2021
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