Healthcare Provider Details

I. General information

NPI: 1346393642
Provider Name (Legal Business Name): FOREST HEALTH SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 FOREST ST
BUHL MN
55713-0724
US

IV. Provider business mailing address

1000 FOREST ST PO BOX 724
BUHL MN
55713-0724
US

V. Phone/Fax

Practice location:
  • Phone: 218-258-8742
  • Fax: 218-258-8767
Mailing address:
  • Phone: 218-258-8742
  • Fax: 218-258-8767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number333238
License Number StateMN

VIII. Authorized Official

Name: MS. DEBRA S DOUGHTY
Title or Position: ADMINISTRATOR PRESIDENT
Credential:
Phone: 218-258-8742