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THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY NPI 1568443570


NPI Information

NPI: 1568443570
Provider Name: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Doing Business As: GOOD SAMARITAN SOCIETY - FOUR CORNERS VILLAGE

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization
Address:
500 CARE LN
AZTEC, NM
ZIP 87410
Phone: (505) 334-9445
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THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY is a skilled nursing facility in Aztec, NM. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY NPI is 1568443570. The provider is registered as an organization entity type.
The provider Is Doing Business As Good Samaritan Society - Four Corners Village.

The provider's business location address is:

500 CARE LN
AZTEC, NM
ZIP 87410-552
Phone: (505) 334-9445
Fax: (505) 334-9577

The provider's authorized official is Raye Nae Nylander .
The authorized official title is Cfo and has the following contact phone number (605) 362-3100.

The enumeration date for this NPI number is 11/7/2005 and was last updated on 1/17/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332BN1400XDurable Medical Equipment & Medical SuppliesNursing Facility SuppliesNo
2332BP3500XDurable Medical Equipment & Medical SuppliesParenteral & Enteral NutritionNo
3314000000XSkilled Nursing FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1=========049OTHERNEW MEXICOTRICARE
2NM00M005OTHERNEW MEXICOBLUE CROSS BLUE SHIELD
30140910019MEDICARE NSCNEW MEXICO
4I0308MEDICAIDNEW MEXICO
5325071MEDICARE OSCAR/CERTIFICATIONSOUTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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