The Evangelical Lutheran Good Samaritan Society

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Practice address

1217 NE Burnside Rd Ste 704
Gresham, OR 97030-5770

Phone

(605) 362-2303

NPI assigned

Mar 7, 2018

Organization subpart

Yes

Parent organization

THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYAs reported in NPPES

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

Authorized official

Name

George Grant Tribble

Title

Executive VP - Finance

Phone

(605) 362-3100

Specialties & licenses 1

Addresses

Other names 1

• Services@Home Doing business as

Tax ID family

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

Part of

Red Oak Iowa Good Sam C

Organizations with this tax ID in the same state 1

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

• The Evangelical Lutheran Good Samaritan Society

  • Skilled Nursing Facility
  • Hermiston, OR
  • NPI 1073594867
  NPD tax ID

Locations

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

{
    "created_epoch": "1520380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1520380800000",
    "number": "1780186536",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 NE BURNSIDE RD STE 704",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305770",
            "telephone_number": "605-362-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY",
        "enumeration_date": "2018-03-07",
        "last_updated": "2018-03-07",
        "status": "A",
        "authorized_official_last_name": "TRIBBLE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "EXECUTIVE VP - FINANCE",
        "authorized_official_telephone_number": "605-362-3100"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Services@Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Biniyam Tesfaye
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• Jade Elisabeth Elaine Thayer
• The Denture Studio
• The Evangelical Lutheran Good Samaritan Society
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• The Wallace Medical Concern
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• In Home Supportive Care Agency in Gresham, OR
• Providers in Gresham, OR by specialty
• In Home Supportive Care Agency in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; 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.