Organization
LAKE SIDE LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABDIRAHIM ISMAIL ISMAIL (RN)
(218) 880-1006
Entity
Organization
Contact information
Practice address
1830 40TH AVE S APT 213, MOORHEAD, MN 56560-7924
(701) 818-5636
Mailing address
1830 40TH AVE S APT 213, MOORHEAD, MN 56560-7924
(701) 818-5636
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
04/21/2026
Last updated
04/21/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us