THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (NPI# 1215918610) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215918610 |
| Entity Type | Organization |
| Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Other Organization Name | GOOD SAMARITAN SOCIETY - PRESCOTT VALLEY |
| Practice Address |
3380 N Windsong Dr Prescott Valley AZ 86314-2262 |
| Mailing Address |
Po Box 5038 Sioux Falls SD 57117-5038 |
| Practice Telephone | 9287750045 |
| Practice Fax Number | 9287752777 |
| Mailing Telephone | 6053623100 |
| Mailing Fax Number | 6053623265 |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2012-12-27 |
| 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 |
|---|---|---|---|
| AZ | 399817 | 05 |
| Other Name | Type Code |
|---|---|
| Good Samaritan Society - Prescott Valley | 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 |
| Washington State Corporations | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 4800 West 57th Street, Sioux Falls, SD 57117 |
| Street Address |
3380 N WINDSONG DR |
| City | PRESCOTT VALLEY |
| State | AZ |
| Zip Code | 86314-2262 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669071700 | Jill Ann Vargas | Occupational Therapy Assistant | 3380 N Windsong Dr, Prescott Valley, AZ 86314-2262 | 2020-10-20 |
| 1760080279 | Adrian Jantzi | Physical Therapy Assistant | 3380 N Windsong Dr, Prescott Valley, AZ 86314-2262 | 2020-10-16 |
| 1225680788 | Jesus Gaquing Jr. | Physical Therapist | 3380 N Windsong Dr, Prescott Valley, AZ 86314-2262 | 2019-07-15 |
| 1831470418 | Ingrid Ann Leonard | Licensed Practical Nurse | 3380 N Windsong Dr, Prescott Valley, AZ 86314-2262 | 2011-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992326029 | Sequelcare of Arizona | Community Based Residential Treatment Facility, Mental Illness | 3001 N. Mountain View Rd, Prescott Valley, AZ 86314 | 2020-04-29 |
| 1124666516 | Best Care Behavioral Homes LLC | Community/Behavioral Health | 5385 W Saddleback Drive, Prescott Valley, AZ 86314 | 2019-12-16 |
| 1912541558 | The Stateserv Companies, LLC | Durable Medical Equipment & Medical Supplies | 8926 E. Long Mesa Drive, Prescott Valley, AZ 86314 | 2019-11-06 |
| 1003398983 | Richard Telck | Pharmacist | 7720 E. Highway 69, Prescott Valley, AZ 86314 | 2018-09-06 |
| 1912493065 | Akdhc,llc | Internal Medicine | 7862 E Florentine Rd, Suite 120, Prescott Valley, AZ 86314 | 2018-07-02 |
| 1700377983 | Pronghorn Psychiatry | Clinic/Center | 5940 E. Copper Hill Dr, Suite E, Prescott Valley, AZ 86314 | 2018-05-23 |
| 1689185126 | Thumb Butte Urgent Care | Clinic/Center | 6496 East Highway 69, Prescott Valley, AZ 86314 | 2017-10-23 |
| 1740738046 | Janine Kauffmann | Pharmacist | 7720 East Highway 69, Prescott Valley, AZ 86314 | 2016-09-14 |
| 1528415650 | Nazcare, Inc. | Exclusive Provider Organization | 8200 E. Jacque Dr., Prescott Valley, AZ 86314 | 2016-05-18 |
| 1184087009 | William Beverly | Marriage & Family Therapist | 8603 E. Eastridge Dr., Ste A, Prescott Valley, AZ 86314 | 2016-03-29 |
| Find all providers in zip 86314 | ||||
| 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 |
|---|---|---|---|---|
| 1023630175 | P. Deanda Medical Pllc | Skilled Nursing Facility | 1950 W Paseo Monserrat, Tucson, AZ 85704-1329 | 2020-05-12 |
| 1477187995 | Welbrook Yuma Opco LLC | Skilled Nursing Facility | 2271 S Ridgeview Dr, Yuma, AZ 85364-8872 | 2020-02-24 |
| 1487215067 | Ludden Healthcare, Inc. | Skilled Nursing Facility | 14660 W Parkwood Dr, Surprise, AZ 85374-4590 | 2019-06-25 |
| 1396208955 | Manuella D Khoshaba | Skilled Nursing Facility | 13821 W Crocus Dr, Surprise, AZ 85379-8340 | 2019-04-10 |
| 1518489244 | Moc Surprise, LLC | Skilled Nursing Facility | 14660 West Parkwood Drive, Surprise, AZ 85374 | 2017-07-14 |
| 1780106765 | Moc Tucson, LLC | Skilled Nursing Facility | 5151 East Pima Street, Tucson, AZ 85712 | 2017-07-12 |
| 1053833038 | Moc Chandler, LLC | Skilled Nursing Facility | 3033 South Arizona Ave., Chandler, AZ 85248 | 2017-07-12 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1609307354 | Tucson Hacienda River, LLC | Skilled Nursing Facility | 2720 E River Road, Tucson, AZ 85718 | 2017-03-24 |
| 1891234126 | Center At Tucson, LLC | Skilled Nursing Facility | 5020 East Glen Street, Tucson, AZ 85712 | 2017-02-20 |
| Find all providers with the same taxonomy | ||||
| City | PRESCOTT VALLEY |
| Zip Code | 86314 |
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.