NPIMap

Organization Active NPI

Lakeshore Community Services

Doing business as Horizon Healthcare

  • Clinic/Center
  • Minneapolis, MN
National Provider Identifier
1437892403
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LAKESHORE COMMUNITY SERVICES
Doing business as
Horizon Healthcare
Practice address
720 W Lake St Ste 105
Minneapolis, MN 55408-2963
Phone
(612) 388-9124
NPI assigned
Apr 18, 2022
Last updated
Nov 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Authorized official

Name
Amir MohamedNPI 1255279881
Title
Board Member
Phone
(612) 388-9124

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU

Addresses

Primary practice location

720 W Lake St Ste 105
Minneapolis, MN 55408-2963

Mailing address

720 W Lake St Ste 105
Minneapolis, MN 55408-2963

Other names 1

  • Horizon Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221228001810 MN Part B Supplier - Clinic/Group Practice 9335519891 Receives reassigned benefits from 3 practitioners
Practice locations: Minneapolis, MN

National Provider Directory

National Provider Directory

Locations

1905 3rd Ave S
Ste Y
Minneapolis, MN 55404

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1650240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1437892403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 W LAKE ST STE 105",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 W LAKE ST STE 105",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082963",
            "telephone_number": "612-388-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-18",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "AMIR",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "612-388-9124"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizon Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.