Organization Active NPI

Forest Health Services Inc.

Doing business as Cornerstone Villa

  • Skilled Nursing Facility
  • Buhl, MN
National Provider Identifier
1346393642
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
333238 Issued in MN
Legal business name
FOREST HEALTH SERVICES INC.
Doing business as
Cornerstone Villa
Practice address
1000 Forest St
Buhl, MN 55713-0724
Phone
(218) 258-8742
Fax
(218) 258-8767
NPI assigned
Jan 19, 2007
Last updated
Sep 25, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Debra S Doughty
Title
Administrator President
Phone
(218) 258-8742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 333238 MN Primary

Addresses

Primary practice location

1000 Forest St
Buhl, MN 55713-0724

Mailing address

1000 Forest St
PO Box 724
Buhl, MN 55713-0724
Phone (218) 258-8742

Other identifiers 4

IdentifierTypeStateIssuer
71 00447OtherMNMEDICA PROVIDER NUMBER
5R32COOtherMNBCBS PROVIDER NUMBER
884696100MedicaidMN
NH0510OtherMNUCARE PROVIDER NUMBER

Other names 1

  • Cornerstone Villa Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040322001030 MN Part A Provider - Skilled Nursing Facility 2062303910 Practice locations: Buhl, MN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346393642. Details of each certification follow.

Skilled nursing facility certification: CCN 245612

Legal name
FOREST HEALTH SERVICES INC
Doing business as
CORNERSTONE VILLA
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 16, 2004
Last certification
Oct 31, 2024
Beds
43
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Enrollment address
1000 Forest St
Buhl, MN 55713-4495
Nursing home name
CORNERSTONE VILLA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Cornerstone VillaCCN 245612 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 16, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
4337.5 residents per day on average
Penalties (3 years)
2Fines totaling $11,243

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
24D1026910Forest Health Services1000 Forest Street, Buhl, MN 55713Certificate of waiverJun 16, 2028

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 7

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jeff Dobson Individual Operational/Managerial Control Jul 1, 2004
Adp of the SNF Jul 1, 2004
Ketti Chamberlin Individual Corporate OfficerBoard Secretary Feb 14, 2022
Corporate DirectorBusiness Office Jul 1, 2022
Operational/Managerial Control Jul 1, 2022
Adp of the SNF Jul 1, 2022
Cassidie R Kunkel Individual Corporate OfficerAdministrator Jul 25, 2022
Corporate DirectorAdministrator Jul 25, 2022
Operational/Managerial Control Jul 25, 2022
Adp of the SNF Jul 25, 2022
Dean M Fox Individual Operational/Managerial Control Jul 1, 2022
Adp of the SNF Jul 1, 2022
Rina Edstrom Individual Corporate DirectorBoard Chair Jul 1, 2023
Operational/Managerial Control Jul 1, 2023
Managing Control - Governing BodyBoard Chair Jul 1, 2023
Adp of the SNF Jul 1, 2023
Donald Carlson Individual Corporate DirectorBoard Chair Jan 1, 2010
Operational/Managerial Control Jan 1, 2010
Adp of the SNF Jan 1, 2010
Lea Sauter Individual Operational/Managerial Control Oct 1, 2022
Adp of the SNF Oct 1, 2022

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380067200000",
    "number": "1346393642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 FOREST ST",
            "address_2": "PO BOX 724",
            "city": "BUHL",
            "state": "MN",
            "postal_code": "557130724",
            "telephone_number": "218-258-8742",
            "fax_number": "218-258-8767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 FOREST ST",
            "city": "BUHL",
            "state": "MN",
            "postal_code": "557130724",
            "telephone_number": "218-258-8742",
            "fax_number": "218-258-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2013-09-25",
        "status": "A",
        "authorized_official_last_name": "DOUGHTY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ADMINISTRATOR     PRESIDENT",
        "authorized_official_telephone_number": "218-258-8742",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MN",
            "license": "333238",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA PROVIDER NUMBER",
            "identifier": "71 00447",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "5R32CO",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "884696100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE PROVIDER NUMBER",
            "identifier": "NH0510",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cornerstone Villa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Buhl, MN

Sources for this page

Verify at the official NPI Registry.