GOOD SAMARITAN SOCIETY - HERITAGE GROVE
NPI 1831170174
Assisted Living Facility in East Grand Forks, MN

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

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since November 11, 2005CLIA 24D1062859 · Waiver

2122 RIVER RD NW, EAST GRAND FORKS, MN 56721(218) 773-7484(218) 773-4287 Get Directions Write a Review

NPPES record last updated: December 13, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Good Samaritan Society - Heritage Grove NPPES

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

GOOD SAMARITAN SOCIETY - HERITAGE GROVE (NPI 1831170174) is a healthcare organization registered as an assisted living facility in East Grand Forks, Minnesota and active in the NPI registry since November 2005. The organization holds a CLIA Waiver certificate valid through December 27, 2026 and lists Raye Nae Nylander, Cfo, as its authorized official.

NPPES Registry Identity

NPI1831170174

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameTHE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY

Location Address2122 RIVER RD NWEast Grand Forks, MN 56721-1065

Mailing AddressPo Box 5038Sioux Falls, SD 57117-5038 · (605) 362-3100 · Fax (605) 362-3265

Phone(218) 773-7484

Fax(218) 773-4287

Organization SubpartNo

Authorized OfficialRaye Nae NylanderCfo · (605) 362-3100

Enumeration DateNovember 11, 2005

Last NPPES UpdateDecember 13, 2012

✔ NPI 1831170174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

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.

2122 RIVER RD NW, East Grand Forks, MN 56721

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Other Names 1

Doing Business AsGood Samaritan Society - Heritage Grove

Other Identifiers 1

Medicaid324819400MN

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 24D1062859

Good Samaritan Heritage Grove · East Grand Forks, MN

Active · expires Dec 27, 2026

CLIA Number24D1062859

Laboratory TypeAssisted Living Facility

Certificate Effective DateDecember 28, 2024

Certificate Expiration DateDecember 27, 2026

Laboratory DirectorMichelle Mostoller

Laboratory Phone(218) 773-7484

Laboratory LocationGood Samaritan Heritage Grove2122 River Road NW, East Grand Forks, MN 56721

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

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 1831170174. It was assigned to this organization in the NPPES registry on November 11, 2005. The provider is doing business as Good Samaritan Society - Heritage Grove.

Where is The Evangelical Lutheran Good Samaritan Society located?

The Evangelical Lutheran Good Samaritan Society is located at 2122 River Rd NW, East Grand Forks, MN 56721. The listed phone number is (218) 773-7484.

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

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

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

Yes. A Certificate of Waiver (number 24D1062859) is associated with this NPI, valid through December 27, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for The Evangelical Lutheran Good Samaritan Society was last updated on December 13, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.