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LAKESIDE MOUNTAIN MANOR OPCO LLC
NPI 1396674503
Custodial Care Facility in Forsyth, MO

Active since May 14, 2026CLIA 26D0955746 · Waiver
238 HARMONY HTS, FORSYTH, MO 65653(417) 546-5595 Get Directions Write a Review

NPPES record last updated: May 14, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Lakeside Mountain Manor Opco Llc NPPES

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

LAKESIDE MOUNTAIN MANOR OPCO LLC (NPI 1396674503), doing business as Lakeside Mountain Manor, is a healthcare organization registered as a custodial care facility in Forsyth, Missouri and active in the NPI registry since May 2026. The organization holds a CLIA Waiver certificate valid through January 7, 2027 and lists Mark Hastings, Owner, as its authorized official.

NPPES Registry Identity

NPI1396674503
Entity TypeOrganization
Primary Taxonomy311Z00000X
Legal Business NameLAKESIDE MOUNTAIN MANOR OPCO LLC
Location Address238 HARMONY HTSForsyth, MO 65653-5533
Mailing Address401 Nw 10th StBlue Springs, MO 64015-3749 · (816) 815-0403
Phone(417) 546-5595
Organization SubpartNo
Authorized OfficialMark HastingsOwner · (417) 399-3819
Enumeration DateMay 14, 2026
NPPES CertifiedMay 14, 2026
✔ NPI 1396674503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care FacilityNursing & Custodial Care Facilities
Taxonomy Code311Z00000X
Definition
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.
238 HARMONY HTS, Forsyth, MO 65653
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Other Names 1

Doing Business AsLakeside Mountain Manor

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 26D0955746

Lakeside Mountain Manor · Forsyth, MO
Active · expires Jan 7, 2027
CLIA Number26D0955746
Laboratory TypeOther
Certificate Effective DateJanuary 8, 2025
Certificate Expiration DateJanuary 7, 2027
Laboratory DirectorJohn Droll
Laboratory Phone(417) 546-5595
Laboratory LocationLakeside Mountain Manor238 Harmony Heights, Forsyth, MO 65653
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

LAKESIDE MOUNTAIN MANOR LLC
Home Health
238 HARMONY HTS
FORSYTH, MO 65653
Taney County (417) 546-5595

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 Lakeside Mountain Manor Opco LLC's NPI number?

The NPI number for Lakeside Mountain Manor Opco LLC is 1396674503. It was assigned to this organization in the NPPES registry on May 14, 2026. The provider is doing business as Lakeside Mountain Manor.

Where is Lakeside Mountain Manor Opco LLC located?

Lakeside Mountain Manor Opco LLC is located at 238 Harmony Hts, Forsyth, MO 65653. The listed phone number is (417) 546-5595.

What is Lakeside Mountain Manor Opco LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility with taxonomy code 311Z00000X.

Does Lakeside Mountain Manor Opco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D0955746) is associated with this NPI, valid through January 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lakeside Mountain Manor Opco LLC was last updated on May 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.