OrganizationActive
Lotus Moon, LLC
NPI 1295339166 · In Home Supportive Care Agency · Minnetonka, MN
Provider details
- NPI number
- 1295339166
- Entity type
- Organization
- Primary specialty
- In Home Supportive Care AgencyAgencies
- Organization subpart
- No
- Authorized official
- Pesey Kuoch, Owner(612) 535-7292
Specialties & taxonomies
Agencies
- Lodging Provider177F00000X
Other Service Providers
- Nursing Care Agency251J00000X
Agencies
- Meals Provider174200000X
Other Service Providers
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
14667 Lake Street Ext
Minnetonka, MN 55345-2926
Phone: (612) 584-0917
Street-level locationGet directions
Mailing address
15401 Lake Street Ext
Minnetonka, MN 55345-1914
Other names (DBA / former)
- Doing business as
- Lotus Moon
Registry dates
- Enumerated
- 2020-11-22
- Last updated
- 2020-11-22
- Certified
- 2020-11-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.