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Organization

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Active
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Other names
Good Samaritan Society - Howard Lake
Organization subpart
Yes

Provider details

NPI number
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Authorized official
MS. RAYE NAE NYLANDER (CFO)
(605) 362-3100
Entity
Organization

Contact information

Practice address
413 13TH AVE, HOWARD LAKE, MN 55349-9409
(320) 543-3800
(320) 543-2305
Mailing address
PO BOX 5038, SIOUX FALLS, SD 57117-5038
(605) 362-3100
(605) 362-3265

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040909001
PRIME WEST
MN
01
1026620
PREFERRED ONE
MN
01
5A17HO
BLUE CROSS BLUE SHIELD
MN
05
608716700
MN
01
7100091
PMAP
MN
01
NH0201
UCARE
MN
Enumeration date
11/11/2005
Last updated
10/25/2021
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