MEDICARE: LAKE-SHORE LAWN AND MORE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	376J00000X	Homemaker
2	305S00000X	Point of Service
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1891685988
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAKE-SHORE LAWN AND MORE LLC

Provider Business Mailing Address
First Line	:	1101 W DALE AVE
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-2248
Country	:	US
Telephone Number	:	231-855-8042
Fax Number	:

Provider Business Practice Location Address
First Line	:	1101 W DALE AVE
Second Line	:
City	:	MUSKEGON
State	:	MI
Zip	:	49441-2248
Country	:	US
Telephone Number	:	231-343-8338
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CLARISSA PONCE
Credential	:
Telephone Number	:	231-343-8338

Provider Enumeration Date	:	07/09/2025
Last Update Date	:	02/11/2026

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Directions to “LAKE-SHORE LAWN AND MORE LLC ” Practice Location

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