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PHS/LAKE MINNETONKA, LLC
NPI 1679997480
Assisted Living Facility in Spring Park, MN

Active since February 13, 2014
3/5
Overall Rating
4527 SHORELINE DR, SPRING PARK, MN 55384(952) 471-4000 Get Directions Write a Review

NPPES record last updated: November 11, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Phs/lake Minnetonka, Llc NPPES

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

PHS/LAKE MINNETONKA, LLC (NPI 1679997480) is a healthcare organization registered as an assisted living facility in Spring Park, Minnesota and active in the NPI registry since February 2014. The organization lists Mark Meyer, Cfo, as its authorized official.

NPPES Registry Identity

NPI1679997480
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePHS/LAKE MINNETONKA, LLC
Location Address4527 SHORELINE DRSpring Park, MN 55384-8706
Mailing Address2845 Hamline Ave NRoseville, MN 55113-7127 · (651) 631-6432 · Fax (651) 631-6122
Phone(952) 471-4000
Organization SubpartNo
Authorized OfficialMark MeyerCfo · (651) 631-6102
Enumeration DateFebruary 13, 2014
Last NPPES UpdateNovember 11, 2025
NPPES CertifiedNovember 11, 2025
✔ NPI 1679997480 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MN · 357277
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.
4527 SHORELINE DR, Spring Park, MN 55384
Open in Google Maps ↗

Other Names 1

Other NameLake Minnetonka Shores

Nursing Home Quality Ratings CMS Care Compare

Quality ratings, staffing and inspection history for Lake Minnetonka Shores (CMS certification number 245210), from CMS Care Compare.

Lake Minnetonka Shores

Nursing home · Spring Park, MN
3/5 CMS Overall Rating
OwnershipNon profit - Corporation
CMS Certification Number245210
Certified Beds60 beds53 residents per day on average
Medicare & Medicaid Participant SinceJanuary 1, 1977
Resident & Family CouncilResident council
Automatic sprinkler system

CMS Star Ratings

Quality Measures
Based on a select set of clinical quality measures.
4/5
Long-Stay Quality
Quality of care delivered to long-term residents.
5/5
Short-Stay Quality
Quality of care delivered to short-term and rehabilitation residents.
2/5
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.
50.33
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 2.36 · LPN 0.62 · RN 1.24
4.22 hrs per resident per day
Weekend Nurse Staffing
3.8 hrs per resident per day
Physical Therapist Staffing
0.19 hrs per resident per day
Nursing Staff Turnover
Share of nursing staff who left the facility within the past year.
46.2%
Registered Nurse Turnover
37.5%
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
4
Fines
1 totaling $8,827.00
Medicare Payment Denials
0
Total Penalties
1
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 Phs/Lake Minnetonka, LLC's NPI number?

The NPI number for Phs/Lake Minnetonka, LLC is 1679997480. It was assigned to this organization in the NPPES registry on February 13, 2014. The provider is also known as Lake Minnetonka Shores.

Where is Phs/Lake Minnetonka, LLC located?

Phs/Lake Minnetonka, LLC is located at 4527 Shoreline Dr, Spring Park, MN 55384. The listed phone number is (952) 471-4000.

What is Phs/Lake Minnetonka, LLC's specialty?

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

Is Phs/Lake Minnetonka, LLC a Medicare-certified nursing home?

Yes. Lake Minnetonka Shores is a Medicare-certified nursing home with 60 certified beds.

What quality rating does Phs/Lake Minnetonka, LLC have?

CMS rates Lake Minnetonka Shores 3 out of 5 stars overall on Care Compare. The full measure detail is in the Nursing Home Quality Ratings section above.

When was this NPI record last updated?

The NPPES record for Phs/Lake Minnetonka, LLC was last updated on November 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.