THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (NPI# 1598755266) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598755266 |
| Entity Type | Organization |
| Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Other Organization Name | GOOD SAMARITAN SOCIETY - MOSCOW VILLAGE |
| Practice Address |
640 N Eisenhower St Moscow ID 83843-9588 |
| Mailing Address |
Po Box 5038 Sioux Falls SD 57117-5038 |
| Practice Telephone | 2088826560 |
| Practice Fax Number | 2088826569 |
| Mailing Telephone | 6053623100 |
| Mailing Fax Number | 6053623265 |
| Enumeration Date | 2005-10-25 |
| 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 |
|---|---|---|---|
| ID | REGENCE BLUE SHIELD | 000010012616 | 01 |
| ID | 000371900 | 05 | |
| ID | BLUE CROSS IDAHO | 01578 | 01 |
| Other Name | Type Code |
|---|---|
| Good Samaritan Society - Moscow 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 |
| Washington State Corporations | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY | 4800 West 57th Street, Sioux Falls, SD 57117 |
| Street Address |
640 N EISENHOWER ST |
| City | MOSCOW |
| State | ID |
| Zip Code | 83843-9588 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790286722 | Lillian R Grady | Occupational Therapy Assistant | 640 N Eisenhower St, Moscow, ID 83843-9588 | 2018-02-25 |
| 1023403805 | Aubrey Diane Weaver | Occupational Therapy Assistant | 640 N Eisenhower St, Moscow, ID 83843-9588 | 2015-03-30 |
| 1366751315 | Frances Anne Preston | Occupational Therapist | 640 N Eisenhower St, Moscow, ID 83843-9588 | 2010-09-24 |
| 1487985198 | Tami Lynn Dial | Speech-Language Pathologist | 640 N Eisenhower St, Moscow, ID 83843-9588 | 2010-01-19 |
| 1891025482 | Annetta Wilson | Specialist | 640 N Eisenhower St, Moscow, ID 83843-9588 | 2010-01-05 |
| 1770818437 | Janie L Jones | Specialist | 640 N Eisenhower St, Moscow, ID 83843-9588 | 2009-10-13 |
| 1154545242 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 640 N Eisenhower St, Moscow, ID 83843-9588 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033726880 | Moscow Physical Therapy, LLC | Clinic/Center | 1174 Alturas Drive, Suite 2, Moscow, ID 83843 | 2020-09-25 |
| 1831703057 | Hydee Flishaw Tubbs Becker | Dietitian, Registered | 614 North Hayes Street, Moscow, ID 83843 | 2020-09-04 |
| 1528626959 | Ryan Steven Clark | Student in an Organized Health Care Education/Training Program | 212 Farm Road, #201, Moscow, ID 83843 | 2019-05-31 |
| 1770141384 | Lingwen Zhang | Specialist/Technologist | 901 Paradise Creek Rd, Moscow, ID 83843 | 2019-05-30 |
| 1306363478 | Elizabeth Campbell | Dietitian, Registered | 611 S. Main, Moscow, ID 83843 | 2017-08-29 |
| 1598285496 | Gina Cretser | Counselor | 212 Rodeo Dr. #410, Moscow, ID 83843 | 2017-06-21 |
| 1124558721 | Morgan Leigh Derloshon | Specialist/Technologist | 275 Southview Ave, Apt 206, Moscow, ID 83843 | 2017-06-15 |
| 1619411790 | Kaylene Howard | Massage Therapist | 127 South Washington, Suite 6, Moscow, ID 83843 | 2016-12-08 |
| 1407237043 | Jacob Kent Christensen | Family Medicine | 831 S Ash St, Moscow, ID 83843 | 2015-06-09 |
| 1366851388 | Elisabeth Henry | Pharmacist | 2740 West Pullman Rd, Moscow, ID 83843 | 2014-08-04 |
| Find all providers in zip 83843 | ||||
| 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 |
|---|---|---|---|---|
| 1366465742 | Kindred Nursing Centers West, LLC | Skilled Nursing Facility | 420 Rowe St, Moscow, ID 83843-9319 | 2006-07-26 |
| 1194236406 | Moscow of Cascadia, LLC | Skilled Nursing Facility | 420 Rowe St, Moscow, ID 83843-9319 | 2017-10-13 |
| 1386041119 | Gritman Medical Center Inc | Skilled Nursing Facility | 700 S Main St, Moscow, ID 83843-3056 | 2014-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801351176 | Tanabell Health Services, Inc. | Skilled Nursing Facility | 2656 E Magicview Dr, Meridian, ID 83646 | 2019-01-31 |
| 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 |
| 1356867683 | Nampa of Cascadia, LLC | Skilled Nursing Facility | 900 North Happy Valley Rd, Nampa, ID 83687 | 2017-08-18 |
| 1851836381 | Tanabell Health Services, Inc | Skilled Nursing Facility | 1134 Cheney Drive West, Twin Falls, ID 83301 | 2016-12-19 |
| 1871042663 | Ahc of Lewiston, LLC | Skilled Nursing Facility | 2852 Juniper Dr, Lewiston, ID 83501-4719 | 2016-09-22 |
| 1063966638 | Boise West of Cascadia, LLC | Skilled Nursing Facility | 8211 Ustick Road, Boise, ID 83704-5756 | 2016-08-11 |
| 1861946436 | Bellevue of Cascadia, LLC | Skilled Nursing Facility | 620 N. 6th Street, Bellevue, ID 83313 | 2016-08-11 |
| 1437603008 | Twin Falls of Cascadia, LLC | Skilled Nursing Facility | 674 Eastland Drive, Twin Falls, ID 83301-6846 | 2016-08-11 |
| 1235683806 | Payette of Cascadia, LLC | Skilled Nursing Facility | 1019 3rd Avenue South, Payette, ID 83661-2832 | 2016-08-11 |
| Find all providers with the same taxonomy | ||||
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| 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.