Lakeside Mountain Manor LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

034594 Issued in MO

Legal business name

LAKESIDE MOUNTAIN MANOR LLC

Practice address

238 Harmony HTS
Forsyth, MO 65653-5533

Phone

(417) 546-5595

Fax

(417) 546-2829

NPI assigned

Aug 15, 2007

Last updated

Aug 15, 2007By 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

Mrs. Debra Jean Droll

Title

Member

Phone

(417) 546-5595

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187136000000",
    "number": "1932391893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "238 HARMONY HTS",
            "city": "FORSYTH",
            "state": "MO",
            "postal_code": "656535533",
            "telephone_number": "417-546-5595",
            "fax_number": "417-546-2829"
        },
        {
            "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",
            "fax_number": "417-546-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE MOUNTAIN MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A",
        "authorized_official_last_name": "DROLL",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "417-546-5595",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MO",
            "license": "034594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Beth A Knox, FNP
• Sasha T Kramer, PHARMD
• Lakeside Mountain Manor Opco LLC (Lakeside Mountain Manor)
• Bill Lauderdale
• Robert H Mace, MA, LPC
• Merry Elizabeth McBride
• Linda J McKinney, FNP

• Home Health Agency in Forsyth, MO
• Providers in Forsyth, MO by specialty
• Home Health Agency in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; 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.