THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY (NPI# 1649640236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649640236 |
| Entity Type | Organization |
| Organization Name | THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY |
| Other Organization Name | GOOD SAMARITAN SOCIETY - HILLSIDE LODGE ASSISTED LIVING |
| Practice Address |
200 Good Samaritan Dr Mountain Home AR 72653-9325 |
| Mailing Address |
4800 W 57th St Sioux Falls SD 57108-2239 |
| Practice Telephone | 8704252494 |
| Mailing Telephone | 6053623100 |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2015-09-25 |
| Authorized Official Name | MR. GRANT TRIBBLE (EXECUTIVE VP - FINANCE) |
| Authorized Official Telephone | 6053623100 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE EV LUTHERAN GOOD SAMARITAN SOCIETY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 166440794 | 05 |
| Other Name | Type Code |
|---|---|
| Good Samaritan Society - Hillside Lodge Assisted Living | 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 |
| 1760861975 | The Evangelical Lutheran Good Samaritan Society | Assisted Living Facility | 1051 Mulberry Street, Taylors Falls, MN 55084 | 2015-05-20 |
| 1043616329 | The Evangelical Lutheran Good Samaritan Society | Home Health | 1104 Jackson Blvd Ste B, Rapid City, SD 57702-4399 | 2014-11-13 |
| 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 |
| Street Address |
200 GOOD SAMARITAN DR |
| City | MOUNTAIN HOME |
| State | AR |
| Zip Code | 72653-9325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513934 | Maranda Hickman | Physical Therapy Assistant | 347 Hwy 62 East College Plaza, Mountain Home, AR 72653 | 2019-11-21 |
| 1659929156 | Gale E Bacan | Technician | 1703 Monroe Ave, Mountain Home, AR 72653 | 2019-08-28 |
| 1891259321 | Kidspiration Pediatric Therapy Services | Clinic/Center | 710 Bradley Dr., Mountain Home, AR 72653 | 2019-01-29 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| 1346769155 | Heather Bollinger | Nurse Practitioner | 65 Walmart Drive, C/o Clinic At Walmart, Mountain Home, AR 72653 | 2017-09-12 |
| 1447774989 | Natalie D Ahrent | Physical Medicine & Rehabilitation | 804 Coley Dr, Mountain Home, AR 72653 | 2017-07-26 |
| 1417486028 | Andrew David Hatman | Case Manager/Care Coordinator | 1349 Hampshire Circle, Mountain Home, AR 72653 | 2017-06-07 |
| 1568848315 | Taylor Chiropractic Plc | Health Maintenance Organization | 103 S Main St Ste 5, Mountain Home, AR 72653 | 2015-08-04 |
| 1942606306 | Harps Food Stores, Inc | Pharmacy | 2089 Highway 62 West, Mountain Home, AR 72653 | 2014-11-13 |
| 1972920726 | Lavonne Armstrong | Counselor | 8 Medical Plaza, Mountain Home, AR 72653 | 2014-03-18 |
| Find all providers in zip 72653 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912299660 | River Lodge Assisted Living LLC | Assisted Living Facility | 117 Riverlodge Drive, Mountain Home, AR 72653 | 2011-05-12 |
| 1942638044 | Bcc Mountain Home Operations, LLC | Assisted Living Facility | 715 W 6th St, Mountain Home, AR 72653-3421 | 2013-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518517127 | Peachtree Village, LLC | Assisted Living Facility | 1500 Fresno St, Fort Smith, AR 72901-7023 | 2019-09-16 |
| 1427539600 | Peachtree Village of Farmington, LLC | Assisted Living Facility | 55 W Rainsong St, Farmington, AR 72730-8635 | 2018-08-24 |
| 1437654670 | Eldercare of Arkansas V, Inc. | Assisted Living Facility | 601 E. Mountain Springs Road, Cabot, AR 72023 | 2018-03-29 |
| 1972007292 | Eldercare of Arkansas IIi, Inc. | Assisted Living Facility | 1306 S. Donaghey, Conway, AR 72034 | 2018-03-21 |
| 1750897039 | Green Acre Easy Lliving | Assisted Living Facility | 2407 W Oak St, Rogers, AR 72758-3943 | 2017-12-21 |
| 1962912626 | Lincolin Co Assisted Living | Assisted Living Facility | 142 Teva Dr, Star City, AR 71667-4253 | 2017-10-09 |
| 1043743768 | Peachtree Village At Holiday Island | Assisted Living Facility | 5 Park Dr, Holiday Island, AR 72631-9388 | 2017-04-10 |
| 1740645456 | Providence PCc of Springdale | Assisted Living Facility | 2175 Orchard St, Springdale, AR 72764-6357 | 2015-12-22 |
| 1427444124 | Holiday Island Operations, LLC | Assisted Living Facility | 89 Hillside Drive, Holiday Island, AR 72631 | 2015-04-09 |
| 1639588585 | Benton Senior Living, LLC | Assisted Living Facility | 1180 Highway 71 S, Mena, AR 71953-3908 | 2014-08-05 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN HOME |
| Zip Code | 72653 |
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.