Lakeshore Assisted Living LLC

Organization Active NPI Assisted Living Facility · Waseca, MN

NPI 1033856166 · NPPES record last updated Sep 13, 2022

Key facts

NPI
1033856166
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
Legal business name
LAKESHORE ASSISTED LIVING LLC
Practice address
105 8TH St NW
Waseca, MN 56093-1907
Phone
(507) 625-8741
NPI assigned
May 19, 2022
Organization subpart
No

Authorized official

Name
Ian Rekant
Title
VP of RCM
Phone
(507) 203-1031

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D2265749Lakeshore Assisted Living
105 8TH St NW, Waseca, MN 56093
Certificate of waiverAug 1, 2026

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Yes

Addresses

Primary practice location

105 8TH St NW
Waseca, MN 56093-1907

Mailing address

638 Southbend Ave
Mankato, MN 56001-2168
Phone (507) 625-8741

Other providers in Waseca, MN

All providers in Waseca, MN · Assisted Living Facility in Minnesota

Sources for this page

Verify at the official NPI Registry.