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THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY NPI 1962673608


NPI Information

NPI: 1962673608
Provider Name: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Doing Business As: GOOD SAMARITAN SOCIETY - FARGO

Classification: Custodial Care Facility - 311Z00000X
Entity Type: Organization

CLIA Number: 35D1076238

Address:
4502 37TH AVE S
FARGO, ND
ZIP 58104
Phone: (701) 282-2651
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THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY is a custodial care facility in Fargo, ND. The provider is a facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel. THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY NPI is 1962673608. The provider is registered as an organization entity type.
The provider Is Doing Business As Good Samaritan Society - Fargo.

The provider's business location address is:

4502 37TH AVE S
FARGO, ND
ZIP 58104-599
Phone: (701) 282-2651
Fax: (701) 282-3027

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

The CLIA number assigned to this NPI record is 35D1076238 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/21/2008 and was last updated on 2/12/2016.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311Z00000XCustodial Care 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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
130777MEDICAIDNORTH 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: 11/14/2023

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