THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Assisted Living Facility
Brainerd, Minnesota
Provider NPI: 1487757852
Organization Information:Organization Name: THE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Practice Location:
2501 GREENWOOD ST SW BRAINERD, MN 56401 US
Tel: 218-825-9364 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
2501 GREENWOOD ST SW BRAINERD, MN 56401 US
Tel: 218-825-9364 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
825430300 | MN | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin