The Evangelical Lutheran Good Samaritan Society

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Practice address

456 C St
Blaine, WA 98230-4238

Phone

(360) 332-8733

Fax

(360) 332-8734

NPI assigned

Apr 12, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Raye Nae Nylander

Title

Vice President, Cfo

Phone

(605) 362-3100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Stafholt Good Samaritan Center Doing business as

Tax ID family

Red Oak Iowa Good Sam C210 organizations share this tax ID, including this one

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• The Evangelical Lutheran Good Samaritan Society

  • Skilled Nursing Facility
  • Blaine, WA
  • NPI 1063403368
  NPPES parent name
• The Evangelical Lutheran Good Samaritan Society

  • Skilled Nursing Facility
  • Spokane Valley, WA
  • NPI 1437130218
  NPPES parent name
• The Evangelical Lutheran Good Samaritan Society

  • Skilled Nursing Facility
  • Fairfield, WA
  • NPI 1578544359
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073737284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 W 57TH ST",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571082239",
            "telephone_number": "605-362-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "456 C ST",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982304238",
            "telephone_number": "360-332-8733",
            "fax_number": "360-332-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NYLANDER",
        "authorized_official_first_name": "RAYE NAE",
        "authorized_official_title_or_position": "VICE PRESIDENT, CFO",
        "authorized_official_telephone_number": "605-362-3100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "700356",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stafholt Good Samaritan Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kenneth Robert Stiver, M.D.
• Megan Elizabeth Stonelake, M.A.
• Nicole Szostak
• Elizabeth Rose Taets Von Amerongen, LPC
• The Evangelical Lutheran Good Samaritan Society
• The Fare Square, LLC
• The Lighthouse Addiction Recovery Centre
• Madeline Lynn Tompkins, MA A
• Touchstone Behavioral Health, LLC
• Touchstone Behavioral Health, LLC

• Assisted Living Facility in Blaine, WA
• Providers in Blaine, WA by specialty
• Assisted Living Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.