Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lake Side Living

Organization In Home Supportive Care Agency · NPI 1669317129

Lake Side Living is an In Home Supportive Care Agency in Moorhead, Minnesota. Registered with an NPI since 2026.

In the registry since
2026

Practice location Address checks out

1830 40th Ave S Apt 213
Moorhead, MN 56560-7924
Phone: (701) 818-5636
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

In Home Supportive Care Agency (primary) Taxonomy 253Z00000X

Record details

NPI number1669317129
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Abdirahim Ismail — Rn · (218) 880-1006
NPI enumeratedApril 21, 2026
Last updated in NPPESApril 21, 2026
Certification dateApril 21, 2026
Mailing address1830 40th Ave S Apt 213, Moorhead, MN 56560-7924

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