OrganizationActive
Lakeside Mountain Manor Opco LLC
NPI 1396674503 · Custodial Care Facility · Forsyth, MO
Provider details
- NPI number
- 1396674503
- Entity type
- Organization
- Primary specialty
- Custodial Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Mark Hastings, Owner(417) 399-3819
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
238 Harmony Hts
Forsyth, MO 65653-5533
Phone: (417) 546-5595
Approximate (ZIP-level) locationGet directions
Mailing address
401 Nw 10th St
Blue Springs, MO 64015-3749
Other names (DBA / former)
- Doing business as
- Lakeside Mountain Manor
Registry dates
- Enumerated
- 2026-05-14
- Last updated
- 2026-05-14
- Certified
- 2026-05-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.