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

PHS/LAKE Minnetonka, LLC

Organization Assisted Living Facility · NPI 1679997480

PHS/LAKE Minnetonka, LLC is an Assisted Living Facility in Spring Park, Minnesota. Licensed in Minnesota. Registered with an NPI since 2014.

Licensed in
MN
In the registry since
2014
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

4527 Shoreline Dr
Spring Park, MN 55384-8706
Phone: (952) 471-4000
Show map & directions

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

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence 357277 (MN)

Record details

NPI number1679997480
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Meyer — Cfo · (651) 631-6102
Other names Lake Minnetonka Shores
NPI enumeratedFebruary 13, 2014
Last updated in NPPESNovember 11, 2025
Certification dateNovember 11, 2025
Mailing address2845 Hamline Ave N, Roseville, MN 55113-7127