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

Lotus Moon, LLC

Organization Meals Provider · NPI 1295339166

Lotus Moon, LLC is a Meals Provider in Minnetonka, Minnesota. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
4
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

14667 Lake Street Ext
Minnetonka, MN 55345-2926
Phone: (612) 584-0917
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
Meals Provider Taxonomy 174200000X
Lodging Provider Taxonomy 177F00000X
Nursing Care Agency Taxonomy 251J00000X

Record details

NPI number1295339166
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Pesey Kuoch — Owner · (612) 535-7292
Other names Lotus Moon
NPI enumeratedNovember 22, 2020
Last updated in NPPESNovember 22, 2020
Certification dateNovember 22, 2020
Mailing address15401 Lake Street Ext, Minnetonka, MN 55345-1914