LAKESIDE MOUNTAIN MANOR OPCO LLC
NPI 1396674503
Custodial Care Facility in Forsyth, MO
NPI Status: Active since May 14, 2026
Contact Information
238 HARMONY HTS
FORSYTH, MO
ZIP 65653
Phone: (417) 546-5595
This NPI profile has been added to the NPI registry within the last 30 days.
- Organization
- Custodial Care Facility
- CLIA Number: 26D0955746
- CLIA Cert. Type: Other
- CLIA Exp. Date: 01-07-2027
About LAKESIDE MOUNTAIN MANOR OPCO LLC
This page provides the complete NPI Profile along with additional information for Lakeside Mountain Manor Opco Llc, a provider established in Forsyth, Missouri operating as a Custodial Care Facility. The healthcare provider is registered in the NPI registry with number 1396674503 assigned on May 2026. The practitioner's primary taxonomy code is 311Z00000X. The provider is registered as an organization and their NPI record was last updated May 2026. The authorized official of this NPI record is Mark Hastings (Owner)
- NPI
- 1396674503
- Provider Name
- LAKESIDE MOUNTAIN MANOR OPCO LLC
- Entity Type
- Organization
- Location Address
- 238 HARMONY HTS FORSYTH, MO 65653
- Location Phone
- (417) 546-5595
- Mailing Address
- 401 NW 10TH ST BLUE SPRINGS, MO 64015
- Mailing Phone
- (816) 815-0403
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-14-2026
- Last Update Date
- 05-14-2026
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Custodial Care Facility
- Taxonomy Code
- 311Z00000X
- Type
- Nursing & Custodial Care Facilities
- Taxonomy Description
- A facility providing care that serves to assist an individual in the activities of daily living, such as assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered. Custodial care essentially is personal care that does not require the continuing attention of trained medical or paramedical personnel.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 26D0955746
- Facility Type
- Other
- Certificate Effective Date
- January 08, 2025
- Certificate Expiration Date
- January 07, 2027
- Laboratory Director
- JOHN DROLL
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Lakeside Mountain Manor Opco Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1396674503, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 67 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396674503, enumerated as an "organization" on May 14, 2026.
The provider is located at 238 HARMONY HTS FORSYTH, MO 65653 and the phone number is (417) 546-5595.
Custodial Care Facility with taxonomy code 311Z00000X.
