| Organization Name: | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| NPI Number: | 1831170174 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAYE NAE NYLANDER (CFO) |
| Mailing Address: | 2122 River Rd Nw East Grand Forks |
| State: | MN US |
| Postal Code: | 567211065 |
| Phone Number: | 2187737484 |
| Fax Number: | 2187734287 |
| NPI Enumeration Date: | 11/11/2005 |
| NPI Last Update Date: | 12/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 04/14/2008 |
| NPI Reactivation Date: | 12/11/2012 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 310400000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Nursing & Custodial Care Facilities |
| Taxonomy Classification: | Assisted Living Facility |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |