OrganizationActive
Lake Side Living
NPI 1669317129 · In Home Supportive Care Agency · Moorhead, MN
Lake Side Living is a In Home Supportive Care Agency organization in Moorhead, MN (NPI 1669317129).
Provider details
- NPI number
- 1669317129
- Entity type
- Organization
- Primary specialty
- In Home Supportive Care AgencyAgencies
- Organization subpart
- No
- Authorized official
- Abdirahim Ismail, RN(218) 880-1006
Specialties & taxonomies
Agencies
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in 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
1830 40th Ave S Apt 213
Moorhead, MN 56560-7924
Phone: (701) 818-5636
Street-level locationGet directions
Mailing address
1830 40th Ave S Apt 213
Moorhead, MN 56560-7924
Registry dates
- Enumerated
- 2026-04-21
- Last updated
- 2026-04-21
- Certified
- 2026-04-21
Frequently asked questions
- What is Lake Side Living's NPI number?
- Lake Side Living's National Provider Identifier (NPI) is 1669317129, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lake Side Living?
- Lake Side Living is classified in the NPPES registry as In Home Supportive Care Agency (Agencies).
- Where is Lake Side Living located?
- Lake Side Living's practice location on file with NPPES is 1830 40th Ave S Apt 213, Moorhead, MN 56560-7924.
- What is Lake Side Living's phone number?
- The practice phone number listed in the NPPES registry for Lake Side Living is (701) 818-5636.
- Who is the authorized official for Lake Side Living?
- The authorized official listed on Lake Side Living's NPPES record is Abdirahim Ismail, RN. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lake Side Living's NPI active?
- Yes — Lake Side Living's NPI (1669317129) is active in the NPPES registry as of the last update on 2026-04-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.