Lakeview Homecare LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LAKEVIEW HOMECARE LLC

Practice address

3655 145TH Ave NW
Andover, MN 55304-3114

Phone

(612) 516-3999

Fax

(612) 887-4376

NPI assigned

Sep 18, 2025

Last updated

Sep 18, 2025By 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

Nicodemus Wuantai NaimoduNPI 1669090619

Title

Assisted Living Director

Phone

(612) 516-3999

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Practitioners 1

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.

• Nicodemus Wuantai Naimodu, RN

  • Registered Nurse
  • Lubbock, TX
  • NPI 1669090619
  NPD Authorized official

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

{
    "created_epoch": "1758153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1558233783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 144TH LN NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553046277",
            "telephone_number": "612-516-3999",
            "fax_number": "612-887-4376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3655 145TH AVE NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043114",
            "telephone_number": "612-516-3999",
            "fax_number": "612-887-4376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVIEW HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-09-18",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "NAIMODU",
        "authorized_official_first_name": "NICODEMUS",
        "authorized_official_middle_name": "WUANTAI",
        "authorized_official_title_or_position": "ASSISTED LIVING DIRECTOR",
        "authorized_official_telephone_number": "612-516-3999"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Lyn Kusilek, LPCC
• Karen Frances La Fond, PHYSICAL THERAPIST
• Cynthia Marie Lachance-Lindberg, MA, LMFT, RPT
• Thomas Edward Lackner, PHARMD
• Rosalynn Judith Lakeman, DC
• Andrea Lane
• Chelsea Lawrence
• Heather Elizabeth Lawrence, SLP
• Anthony George Lawther, D.C.
• Kayla Lynn Lefevere, LICSW

• Assisted Living Facility in Andover, MN
• Providers in Andover, MN by specialty
• Assisted Living Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.