Healthcare Provider Details

I. General information

NPI: 1396727004
Provider Name (Legal Business Name): LUTHERAN HOME OF THE GOOD SHEPHERD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1226 1ST AVE N
NEW ROCKFORD ND
58356-1415
US

IV. Provider business mailing address

1226 1ST AVE N
NEW ROCKFORD ND
58356-1415
US

V. Phone/Fax

Practice location:
  • Phone: 701-947-2944
  • Fax: 701-947-2273
Mailing address:
  • Phone: 701-947-2944
  • Fax: 701-947-2273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number StateND
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number StateND
# 4
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1043A
License Number StateND

VIII. Authorized Official

Name: MS. KIM DROSKE
Title or Position: ADMINISTRATOR, CEO
Credential: HSE
Phone: 701-947-2944