Organization
LAKESIDE MOUNTAIN MANOR OPCO LLC
Active
Other names
Lakeside Mountain Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MARK HASTINGS (OWNER)
(417) 399-3819
Entity
Organization
Contact information
Practice address
238 HARMONY HTS, FORSYTH, MO 65653-5533
(417) 546-5595
Mailing address
401 NW 10TH ST, BLUE SPRINGS, MO 64015-3749
(816) 815-0403
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
05/14/2026
Last updated
05/14/2026
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