Lakeside Mountain Manor Opco LLC

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

Legal business name

LAKESIDE MOUNTAIN MANOR OPCO LLC

Doing business as

Lakeside Mountain Manor

Practice address

238 Harmony HTS
Forsyth, MO 65653-5533

Phone

(417) 546-5595

NPI assigned

May 14, 2026

Last updated

May 14, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Hastings

Title

Owner

Phone

(417) 399-3819

Specialties & licenses 1

Addresses

Other names 1

• Lakeside Mountain Manor Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1778716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778716800000",
    "number": "1396674503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 NW 10TH ST",
            "city": "BLUE SPRINGS",
            "state": "MO",
            "postal_code": "640153749",
            "telephone_number": "816-815-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "238 HARMONY HTS",
            "city": "FORSYTH",
            "state": "MO",
            "postal_code": "656535533",
            "telephone_number": "417-546-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MOUNTAIN MANOR OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-14",
        "last_updated": "2026-05-14",
        "certification_date": "2026-05-14",
        "status": "A",
        "authorized_official_last_name": "HASTINGS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "417-399-3819"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakeside Mountain Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Beth A Knox, FNP
• Sasha T Kramer, PHARMD
• Lakeside Mountain Manor LLC
• Bill Lauderdale
• Robert H Mace, MA, LPC
• Merry Elizabeth McBride
• Linda J McKinney, FNP
• Mercy Clinic-Springfield Communities (Mercy Clinic Family Medicine-Forsyth)

• Custodial Care Facility in Forsyth, MO
• Providers in Forsyth, MO by specialty
• Custodial Care Facility in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.