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GOOD SAMARITAN SOCIETY - THE VILLAGE
NPI 1265423990
Skilled Nursing Facility in Mountain Lake, MN

Active since November 02, 2005CLIA 24D0664275 · Waiver
5/5
Overall Rating
745 BASINGER MEMORIAL DR, MOUNTAIN LAKE, MN 56159(507) 427-2464(507) 427-3036 Get Directions Write a Review

NPPES record last updated: November 28, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Good Samaritan Society - The Village NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GOOD SAMARITAN SOCIETY - THE VILLAGE (NPI 1265423990) is a healthcare organization registered as a skilled nursing facility in Mountain Lake, Minnesota and active in the NPI registry since November 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Raye Nae Nylander, Cfo, as its authorized official.

NPPES Registry Identity

NPI1265423990
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameTHE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Location Address745 BASINGER MEMORIAL DRMountain Lake, MN 56159-1312
Mailing AddressPo Box 5038Sioux Falls, SD 57117-5038 · (605) 362-3100 · Fax (605) 362-3265
Phone(507) 427-2464
Fax(507) 427-3036
Organization SubpartYes
Authorized OfficialRaye Nae NylanderCfo · (605) 362-3100
Enumeration DateNovember 2, 2005
Last NPPES UpdateNovember 28, 2021
NPPES CertifiedNovember 28, 2021
✔ NPI 1265423990 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(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.
Also ListedDurable Medical Equipment & Medical Supplies · Nursing Facility SuppliesTaxonomy 332BN1400X
Also ListedDurable Medical Equipment & Medical Supplies · Parenteral & Enteral NutritionTaxonomy 332BP3500X
745 BASINGER MEMORIAL DR, Mountain Lake, MN 56159
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Other Names 1

Doing Business AsGood Samaritan Society - The Village

Other Identifiers 4

Medicaid115180100MN
Medicaid477840500MN
Other4690MOMN · Blue Cross Blue Shield
OtherNH0330MN · Ucare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica, Sanford Health Plan.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D0664275

Good Samaritan Village · Mountain Lake, MN
Active · expires Aug 31, 2026
CLIA Number24D0664275
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorMaria M. Flor
Laboratory Phone(507) 427-2464
Laboratory LocationGood Samaritan Village745 Basinger Memorial Drive, Mountain Lake, MN 56159
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Good Samaritan Society - Mountain Lake (CMS certification number 245549), from CMS Care Compare.

Good Samaritan Society - Mountain Lake

Nursing home · Mountain Lake, MN
5/5 CMS Overall Rating
OwnershipNon profit - Corporation
CMS Certification Number245549
Certified Beds48 beds45 residents per day on average
Medicare & Medicaid Participant SinceFebruary 1, 1991
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
3/5
Long-Stay Quality
Quality of care delivered to long-term residents.
3/5
Staffing
Based on nursing staff hours relative to resident needs.
5/5
Weighted Health Inspection Score
Lower scores are better; the score summarizes deficiencies found on recent inspections.
28
Ratings are assigned by CMS on a one-to-five star scale; five is the highest. Categories without a current CMS rating are not shown.

Staffing & Turnover

Total Nurse Staffing
nurse aide 2.13 · LPN 0.57 · RN 0.9
3.59 hrs per resident per day
Weekend Nurse Staffing
2.94 hrs per resident per day
Physical Therapist Staffing
0 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
26.3%
Registered Nurse Turnover
11.1%
Administrators Who Have Left
In the past year.
0
Higher staffing hours generally allow more direct care time per resident.

Inspections & Enforcement

Facility-Reported Incidents
0
Substantiated Complaints
0
Infection-Control Citations
0
Fines
0
Medicare Payment Denials
0
Total Penalties
0
Counts come from CMS inspections and complaint investigations over approximately the past three years. CMS Care Compare data as of October 1, 2024.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is The Evangelical Lutheran Good Samaritan Society's NPI number?

The NPI number for The Evangelical Lutheran Good Samaritan Society is 1265423990. It was assigned to this organization in the NPPES registry on November 2, 2005. The provider is doing business as Good Samaritan Society - The Village.

Where is The Evangelical Lutheran Good Samaritan Society located?

The Evangelical Lutheran Good Samaritan Society is located at 745 Basinger Memorial Dr, Mountain Lake, MN 56159. The listed phone number is (507) 427-2464.

What is The Evangelical Lutheran Good Samaritan Society's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does The Evangelical Lutheran Good Samaritan Society hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D0664275) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

Is The Evangelical Lutheran Good Samaritan Society a Medicare-certified nursing home?

Yes. Good Samaritan Society - Mountain Lake is a Medicare-certified nursing home with 48 certified beds.

What quality rating does The Evangelical Lutheran Good Samaritan Society have?

CMS rates Good Samaritan Society - Mountain Lake 5 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

What insurance does The Evangelical Lutheran Good Samaritan Society accept?

Health plans from HealthPartners, Medica and Sanford Health Plan list The Evangelical Lutheran Good Samaritan Society as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for The Evangelical Lutheran Good Samaritan Society was last updated on November 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.