NPIMap

Organization Active NPI

The Evangelical Lutheran Good Samaritan Society

Doing business as Good Samaritan Society- Home Care

  • In Home Supportive Care Agency
  • Robbinsdale, MN
National Provider Identifier
1851853816
Registry record updated Jul 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Doing business as
Good Samaritan Society- Home Care
Services@Home - MN Metro
Practice address
4080 W Broadway Ave Ste 132
Robbinsdale, MN 55422-5605
Phone
(763) 324-7924
Fax
(763) 208-6738
NPI assigned
Apr 1, 2019
Last updated
Jul 15, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 15, 2021

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

Authorized official

Name
Eric Vanden Hull
Title
VP - Finance
Phone
(605) 362-5510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

4080 W Broadway Ave Ste 132
Robbinsdale, MN 55422-5605

Mailing address

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

Other practice location 1

1415 Lilac Dr N Ste 260
Golden Valley, MN 55422-4545
Phone (855) 232-3443

Other names 2

  • Good Samaritan Society- Home Care Doing business as
  • Services@Home - MN Metro Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Good Samaritan Home210 organizations share this tax ID, including this one
Part of
Good Samaritan Home

Organizations with this tax ID in the same state 17

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

View all 17

Locations

1415 Lilac Dr N
Ste 260
Golden Valley, MN 55422
Phone (763) 496-1516

NPI Registry JSON

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626307200000",
    "number": "1851853816",
    "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": "4080 W BROADWAY AVE STE 132",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554225605",
            "telephone_number": "763-324-7924",
            "fax_number": "763-208-6738"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Lilac Dr N Ste 260",
            "address_purpose": "LOCATION",
            "city": "Golden Valley",
            "state": "MN",
            "postal_code": "554224545",
            "country_code": "US",
            "telephone_number": "855-232-3443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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": "2019-04-01",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A",
        "authorized_official_last_name": "VANDEN HULL",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "VP - FINANCE",
        "authorized_official_telephone_number": "605-362-5510"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Samaritan Society- Home Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Services@Home - MN Metro",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Robbinsdale, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.