GOOD SAMARITAN SOCIETY - DAYTONA
NPI 1962484022
Skilled Nursing Facility in Daytona Beach, FL

Active since November 15, 2005CLIA 10D0022673 · Waiver
325 S SEGRAVE ST, DAYTONA BEACH, FL 32114(386) 253-6791(386) 258-3842 Get Directions Write a Review

NPPES record last updated: October 25, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Good Samaritan Society - Daytona NPPES

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

GOOD SAMARITAN SOCIETY - DAYTONA (NPI 1962484022) is a healthcare organization registered as a skilled nursing facility in Daytona Beach, Florida and active in the NPI registry since November 2005. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Eric Vanden Hull, Vp, Finance, as its authorized official.

NPPES Registry Identity

NPI1962484022
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameTHE EVANGELICAL LUTHERAN GOOD SAMARITAN SOCIETY
Location Address325 S SEGRAVE STDaytona Beach, FL 32114-4220
Mailing AddressPo Box 5038Sioux Falls, SD 57117-5038 · (605) 362-3100 · Fax (605) 362-3265
Fax(386) 258-3842
Organization SubpartYes
Authorized OfficialEric Vanden HullVp, Finance · (605) 362-3100
Enumeration DateNovember 15, 2005
Last NPPES UpdateOctober 25, 2021
NPPES CertifiedOctober 25, 2021
NPI 1962484022 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.
325 S SEGRAVE ST, Daytona Beach, FL 32114

Other Names 1

Doing Business AsGood Samaritan Society - Daytona

Other Identifiers 5

Medicaid020439100FL
Medicaid675714601FL
Other7100409FL · Evercare
OtherK2SFL · Blue Cross Blue Shield
Other141221300FL · Medicaid Alf Oss

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 10D0022673

Good Samaritan Society-Daytona · Daytona Beach, FL
Active · expires Aug 31, 2026
CLIA Number10D0022673
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorTabbitha Cook
Laboratory Phone(386) 253-6791
Laboratory LocationGood Samaritan Society-Daytona325 S Segrave St, Daytona Beach, FL 32114
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
325 S SEGRAVE ST
DAYTONA BEACH, FL 32114
Nurse Practitioner (Family)
325 S SEGRAVE ST
DAYTONA BEACH, FL 32114
Physical Therapist
325 S SEGRAVE ST
DAYTONA BEACH, FL 32114
Physical Therapist
325 S SEGRAVE ST
DAYTONA BEACH, FL 32114
Skilled Nursing Facility
325 S SEGRAVE ST
DAYTONA BEACH, FL 32114

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 1962484022. It was assigned to this organization in the NPPES registry on November 15, 2005. The provider is doing business as Good Samaritan Society - Daytona.

Where is The Evangelical Lutheran Good Samaritan Society located?

The Evangelical Lutheran Good Samaritan Society is located at 325 S Segrave St, Daytona Beach, FL 32114. The listed phone number is (386) 253-6791.

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 10D0022673) is associated with this NPI, valid through August 31, 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 October 25, 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.