NPIMap

Organization Active NPI

The Evangelical Lutheran Good Samaritan

Doing business as The Manor at Bonell Good Samaritan Center

  • Assisted Living Facility
  • Greeley, CO
National Provider Identifier
1760505705
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN
Doing business as
The Manor at Bonell Good Samaritan Center
Practice address
708 22ND St
Greeley, CO 80631-7041
Phone
(970) 352-6082
Fax
(970) 356-7970
NPI assigned
Apr 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

708 22ND St
Greeley, CO 80631-7041

Mailing address

4800 W 57TH St
Sioux Falls, SD 57108-2239
Phone (605) 362-3100

Other identifiers 1

IdentifierTypeStateIssuer
02372380MedicaidCO

Other names 1

  • The Manor at Bonell Good Samaritan Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Cent210 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 9

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760505705",
    "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": "708 22ND ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806317041",
            "telephone_number": "970-352-6082",
            "fax_number": "970-356-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02372380",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Manor at Bonell Good Samaritan Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greeley, CO

Sources for this page

  • 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.