Organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Active
Other names
Robbinsdale Good Samaritan Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RAYE NAE NYLANDER (VICE PRESIDENT CFO)
(605) 362-3100
Entity
Organization
Contact information
Practice address
3815 W BROADWAY AVE, ROBBINSDALE, MN 55422-2207
(763) 588-4635
(763) 588-9405
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1026653
PREFERRED ONE
MN
05
—
5A13CR
ASSISTED LIVING
MN
01
—
7110090
MEDICA CHOICE
MN
01
—
7111785
EVERCARE (MEDICA)
MN
01
—
NH0014
UCARE OF MN
MN
Enumeration date
10/26/2005
Last updated
07/19/2007
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