Capeside Cove Good Samaritan Center

LBN: The Evangelical Lutheran Good Samaritan Society
Capeside Cove Good Samaritan Center is an health care organization with primary practice located at 23926 4Th Ave S , Siren WI 54872-8334. The organization recently has 2 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Skilled Nursing Facility, Suppliers / Nursing Facility Supplies. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. The Evangelical Lutheran Good Samaritan Society can be contacted via phone (715) 349-2292, or through Nylander, Raye Nae via phone (605) 362-3100.

Contact Information

Primary practice address
23926 4Th Ave S Siren WI 54872-8334
Phone: (715) 349-2292
Fax: (715) 349-7218
Website:
Map and Directions
Authorized official contact:
Name: Nylander, Raye Nae
Phone: (605) 362-3100

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X
Suppliers / Nursing Facility Supplies 332BN1400X

Profile Details

NPI number 1235110016
LBN Legal business name The Evangelical Lutheran Good Samaritan Society
DBA Doing business as Capeside Cove Good Samaritan Center
Authorized official Nylander, Raye Nae
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 9th, 2005
Last updated Nov 9th, 2007 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235110016 NPPES
Wisconsin MEDICAID 20158900
Wisconsin Other 1026758
Wisconsin Other 7122742
Wisconsin Other 9840CA
Wisconsin Other 1014259

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