THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (NPI# 1053392548) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053392548 |
| Entity Type | Organization |
| Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Other Organization Name | GOOD SAMARITAN SOCIETY - BOISE VILLAGE |
| Practice Address |
3115 N Sycamore Dr Boise ID 83703-4129 |
| Mailing Address |
Po Box 5038 Sioux Falls SD 57117-5038 |
| Practice Telephone | 2083437726 |
| Practice Fax Number | 2083438987 |
| Mailing Telephone | 6053623100 |
| Mailing Fax Number | 6053623265 |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2013-01-11 |
| Authorized Official Name | MS. RAYE NAE NYLANDER (CFO) |
| Authorized Official Telephone | 6053623100 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
Suppliers | ||
| N | 332BN1400X |
Durable Medical Equipment & Medical Supplies Specialization: Nursing Facility Supplies |
Suppliers | ||
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | REGENCE | 0000100129001 | 01 |
| ID | 000371800 | 05 | |
| ID | MEDICAID ID - TBI PROGRAM | 805490400 | 01 |
| ID | BC - IDAHO | 01123 | 01 |
| Other Name | Type Code |
|---|---|
| Good Samaritan Society - Boise Village | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497217251 | The Evangelical Lutheran Good Samaritan Society | In Home Supportive Care | 45-090 Namoku St. Cottage H, Kaneohe, HI 96744 | 2019-04-02 |
| 1851853816 | The Evangelical Lutheran Good Samaritan Society | In Home Supportive Care | 1415 Lilac Dr N Ste 260, Golden Valley, MN 55422-4545 | 2019-04-01 |
| 1740769595 | The Evangelical Lutheran Good Samaritan Society | Nurse Practitioner | 301 S Highway 12b, Park River, ND 58270 | 2018-08-13 |
| 1952888414 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 2765 Virginia Avenue N., New Hope, MN 55427 | 2018-07-26 |
| 1780186536 | The Evangelical Lutheran Good Samaritan Society | In Home Supportive Care | 1217 Ne Burnside Rd Ste 704, Gresham, OR 97030-5770 | 2018-03-07 |
| 1881112290 | The Evangelical Lutheran Good Samaritan Society | Skilled Nursing Facility | 4825 Jericho Way, Rapid City, SD 57702-9694 | 2017-09-06 |
| 1982154993 | The Evangelical Lutheran Good Samaritan Society | Clinic/Center | 216 Samaritan Cir, Belington, WV 26250-8141 | 2016-10-13 |
| 1659725364 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 400 S Mckinley St, Warren, MN 56762-1439 | 2016-04-19 |
| 1649640236 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 200 Good Samaritan Dr, Mountain Home, AR 72653-9325 | 2015-09-25 |
| 1760861975 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 1051 Mulberry Street, Taylors Falls, MN 55084 | 2015-05-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 4800 West 57th Street,p.o. Box 5038, Sioux Falls, SD 57117-5038 |
| Oregon Corporations, Companies and Business Names | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 4800 West 57th Street, Sioux Falls, SD 57117 |
| Iowa Business Entities | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Cothe Evangelical Lutheran Good Samaritan Society, 4800 West 57th Streetp.o. Box 5038, Sioux Falls, SD 57117 |
| Ohio Business Entities | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 4800 West 57th Street, Po Box 5038, Sioux Falls, SD 57117-5038 |
| Indiana Business Entities | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | Po Box 5038, 4800 West 57th Street, Sioux Falls, SD 57117-5038 |
| Oklahoma Business Registrations | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | The, 1000 W. Avenue North, Sioux Falls, SD 57104-0000 |
| Street Address |
3115 N SYCAMORE DR |
| City | BOISE |
| State | ID |
| Zip Code | 83703-4129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386018521 | Moises Joshua Albano | Physical Therapy Assistant | 3115 N Sycamore Dr, Boise, ID 83703-4129 | 2015-11-27 |
| 1023401825 | Kelli Shaw | Speech-Language Pathologist | 3115 N Sycamore Dr, Boise, ID 83703-4129 | 2015-03-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386203974 | Dylan Roy | Chiropractor | 5632 W State Street, Boise, ID 83703 | 2019-06-07 |
| 1124476858 | Tidwell Social Work Services and Consulting, Inc. | Community/Behavioral Health | 5999 W. State St., Boise, ID 83703 | 2016-06-03 |
| 1801251244 | Rebecca Lynn Cushing | Massage Therapist | 5909 W. State St, Boise, ID 83703 | 2015-12-30 |
| 1790181675 | Malinda Poe | Counselor | 4440 W Taft St, Boise, ID 83703 | 2014-11-05 |
| 1689079469 | Ashley Harker | Massage Therapist | 5909 W. State St., Boise, ID 83703 | 2014-10-23 |
| 1770987844 | Brick House Recovery | Counselor | 3663 N Lakeharbor Ln, Boise, ID 83703 | 2014-10-17 |
| 1033512538 | Ryan Warburton | Physical Therapist | 2999 N Lakeshore Lane, Ste 120, Boise, ID 83703 | 2014-09-29 |
| 1710386008 | Suzanne Iannaccone | Social Worker | 4090 W State St Ste 221, Boise, ID 83703 | 2014-08-22 |
| 1588092464 | Becky L. Marks | Social Worker | 3858 N. Garden Center Way, Suite 204, Boise, ID 83703 | 2013-10-31 |
| 1700219169 | Pohley Richey | Dietitian, Registered | 6052 W State Street, Boise, ID 83703 | 2013-08-20 |
| Find all providers in zip 83703 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497233514 | Boise Nursing and Rehab Center LLC | Skilled Nursing Facility | 1140 N Allumbaugh St, Boise, ID 83704-8716 | 2018-07-31 |
| 1295249241 | Boise of Cascadia, LLC | Skilled Nursing Facility | 6000 W. Denton St., Boise, ID 83706 | 2017-11-29 |
| 1063966638 | Boise West of Cascadia, LLC | Skilled Nursing Facility | 8211 Ustick Road, Boise, ID 83704-5756 | 2016-08-11 |
| 1407239973 | Humangood Idaho | Skilled Nursing Facility | 5301 E Warm Springs Ave, Boise, ID 83716 | 2015-07-02 |
| 1265782189 | Snf Boise Operating Company LLC | Skilled Nursing Facility | 3550 Americana Terrace, Boise, ID 83706 | 2012-09-18 |
| 1679677991 | Marquis Companies I, Inc | Skilled Nursing Facility | 909 Reserve St, Boise, ID 83712-6508 | 2006-09-08 |
| 1194762815 | Peak Medical of Boise LLC | Skilled Nursing Facility | 8211 W Ustick Rd, Boise, ID 83704-5756 | 2006-06-01 |
| 1184678617 | Emerald Medical Investors, LLC | Skilled Nursing Facility | 502 N Kimball Pl, Boise, ID 83704-0608 | 2006-05-20 |
| 1942254487 | Valley View Investors, LLC | Skilled Nursing Facility | 1140 North Allumbaugh Street, Boise, ID 83704-8700 | 2006-05-20 |
| 1225081284 | Life Care Centers of America, Inc. | Skilled Nursing Facility | 808 N Curtis Rd, Boise, ID 83706-1306 | 2006-05-18 |
| Find all providers in BOISE | ||||
Please comment or provide details below to improve the information on THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.