NPI 1629176383

The Evangelical Lutheran Good Samaritan Society

Organisation Assisted Living Facility Brainerd, MN

Practice location

Address: 2509 Greenwood St SW, Brainerd, MN 56401-8340
Phone: (218) 829-5405
Fax: (218) 829-5485
Mailing address: PO Box 5038 4800 W 57th St, Sioux Falls, SD 57117-5038

Authorised official

Name: Raye Nae Nylander
Title: Cfo
Phone: (605) 362-3100

Registered specialties

Assisted Living Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310400000X

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Registry record

NPI: 1629176383
Entity type: Organization
NPI issued: 20 Sep 2006
Record last updated: 14 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.