Organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Active
Other names
Victorian Legacy
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
1160 SUNRISE ST, SUPERIOR, NE 68978-2344
(402) 879-3099
(402) 879-3445
Mailing address
4800 W 57TH ST, SIOUX FALLS, SD 57108-2239
(605) 362-3100
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025321600
—
NE
Enumeration date
02/13/2007
Last updated
08/22/2020
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