NPIMap

Organization Active NPI

Souris Valley Care Center, Inc.

Doing business as Souris Valley Care Center

  • Skilled Nursing Facility
  • Velva, ND
National Provider Identifier
1306821087
Registry record updated Apr 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1091A Issued in ND
Legal business name
SOURIS VALLEY CARE CENTER, INC.
Doing business as
Souris Valley Care Center
Practice address
300 Main St S
Velva, ND 58790-7342
Phone
(701) 338-2072
Fax
(701) 338-2031
NPI assigned
Dec 14, 2005
Last updated
Apr 18, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2011

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

Authorized official

Name
Ms. Raye Nae B Nylander, LNHA
Title
Cfo, Executive Vice President
Phone
(605) 362-3100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 025 ND
Skilled Nursing Facility 314000000X 1091A ND Primary

Addresses

Primary practice location

300 Main St S
Velva, ND 58790-7342

Mailing address

300 Main St S
Velva, ND 58790-7342
Phone (701) 338-2072

Other names 1

  • Souris Valley Care Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050705000945 ND Part A Provider - Skilled Nursing Facility 9830135417 Practice locations: Velva, ND

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1306821087. Details of each certification follow.

Skilled nursing facility certification: CCN 355109

Legal name
SOURIS VALLEY CARE CENTER, INC.
Doing business as
SOURIS VALLEY CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 1, 1991
Last certification
Apr 24, 2025
Beds
46
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Dec 5, 1977 in ND
Enrollment address
300 Main St S
Velva, ND 58790-7342
Nursing home name
SOURIS VALLEY CARE CENTER
Affiliated entity
GOOD SAMARITAN SOCIETY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Souris Valley Care CenterCCN 355109 · All quality measures
Overall star rating
1 of 5
Health inspections
1 of 5
Staffing
2 of 5
Quality measures
1 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Sep 1, 1991
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4640.3 residents per day on average
Chain
Good Samaritan Society92 facilities in the chain
Special focus status
SFF Candidate
Penalties (3 years)
4Fines totaling $175,053

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Souris Valley Care Center2 organizations share this tax ID, including this one
Part of
Perkins Pavillion

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

300 Main St S
Velva, ND 58790
Phone (701) 338-2072

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bonnie Thom Individual Corporate DirectorBoard Member May 28, 2014
The Evangelical Lutheran Good Samaritan Society Organization, Sioux Falls, SD Operational/Managerial Control Sep 1, 1991
Mary Liz Davis Individual Corporate DirectorSecretary May 28, 2014
Larry Lee Individual Corporate DirectorBoard Member May 28, 2014
Alvin Finneseth Individual Corporate DirectorPresdent May 28, 2014
Operational/Managerial Control Feb 1, 2012
Valerie Heisler Individual Corporate DirectorBoard Member May 28, 2014
David Kramer Individual Corporate DirectorConsultant May 28, 2014
Dan Flaherty Individual Corporate DirectorBoard Member May 28, 2014

Facilities with the same owner 106

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 106

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303084800000",
    "number": "1306821087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MAIN ST S",
            "city": "VELVA",
            "state": "ND",
            "postal_code": "587907342",
            "telephone_number": "701-338-2072",
            "fax_number": "701-338-2031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MAIN ST S",
            "city": "VELVA",
            "state": "ND",
            "postal_code": "587907342",
            "telephone_number": "701-338-2072",
            "fax_number": "701-338-2031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURIS VALLEY CARE CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
        "enumeration_date": "2005-12-14",
        "last_updated": "2011-04-18",
        "status": "A",
        "authorized_official_last_name": "NYLANDER",
        "authorized_official_first_name": "RAYE NAE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO, EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "605-362-3100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LNHA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ND",
            "license": "025",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ND",
            "license": "1091A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Souris Valley Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Velva, ND

Sources for this page

Verify at the official NPI Registry.