Healthcare Provider Details

I. General information

NPI: 1336327188
Provider Name (Legal Business Name): THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/04/2008
Last Update Date: 02/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 OAK DR
LUVERNE MN
56156-1792
US

IV. Provider business mailing address

4800 W 57TH ST
SIOUX FALLS SD
57108-2239
US

V. Phone/Fax

Practice location:
  • Phone: 507-283-2375
  • Fax: 507-283-8393
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RAYE NAE NYLANDER
Title or Position: VICE PRESIDENT, CFO
Credential:
Phone: 605-362-3100