Lotus Moon, LLC
In Home Supportive Care in Minnetonka, MN. Organization (NPI-2).
NPI number1295339166
StatusActive
Last updated in NPPESNov 22, 2020
Details
- NPI
- 1295339166
- Entity type
- Organization (NPI-2)
- Legal business name
- Lotus Moon, LLC
- Organization subpart
- No
- Enumeration date
- Nov 22, 2020
- Certification date
- Nov 22, 2020
- Last updated
- Nov 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
| 177F00000X | Lodging | – | – | |
| 251J00000X | Nursing Care | – | – | |
| 174200000X | Meals | – | – |
Other names
- Lotus Moon (Doing Business As)
Practice location
14667 Lake Street ExtMinnetonka, MN 55345-2926
Phone 612-584-0917
Mailing address
15401 Lake Street ExtMinnetonka, MN 55345-1914
Phone 612-535-7292
Authorized official
Pesey M Kuoch
Owner
6125357292
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All 7 In Home Supportive Care Agency providers in Minnetonka · All 2,873 providers in Minnetonka
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