NPIMap

Organization Active NPI

Forest Haven Nursing & Rehabilitation Center, LLC

Doing business as Forest Haven Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • Jonesboro, LA
National Provider Identifier
1366423550
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
712 Issued in LA
Legal business name
FOREST HAVEN NURSING & REHABILITATION CENTER, LLC
Doing business as
Forest Haven Nursing & Rehabilitation Center
Practice address
171 Thrasher Dr
Jonesboro, LA 71251-4125
Phone
(318) 259-2729
Fax
(318) 259-2977
NPI assigned
Nov 7, 2005
Last updated
Sep 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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

Authorized official

Name
Mr. Teddy Ray Price
Title
Managing Member
Phone
(318) 628-4116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 712 LA Primary

Addresses

Primary practice location

171 Thrasher Dr
Jonesboro, LA 71251-4125

Mailing address

171 Thrasher Dr
Jonesboro, LA 71251-4125
Phone (318) 259-2729

Other identifiers 1

IdentifierTypeStateIssuer
1520934MedicaidLA

Other names 1

  • Forest Haven Nursing & Rehabilitation Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100112000278 LA Part A Provider - Skilled Nursing Facility 6800937988 Practice locations: Jonesboro, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1366423550. Details of each certification follow.

Skilled nursing facility certification: CCN 195463

Legal name
FOREST HAVEN NURSING & REHABILITATION CENTER, LLC
Doing business as
FOREST HAVEN NURSING & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Apr 1, 1998
Last certification
Apr 30, 2025
Beds
139
Ownership / control type
Corporation
Multi-facility organization
Central Management Company, LLc
Organization structure
LLCProprietary
Enrollment address
171 Thrasher Dr
Jonesboro, LA 71251-4125
Nursing home name
FOREST HAVEN NURSING & REHAB CTR, LLC
Affiliated entity
CENTRAL MANAGEMENT COMPANY

Care Compare: Nursing home

Medicare Care Compare
Listed as
Forest Haven Nursing & Rehab Ctr, LLCCCN 195463 · All quality measures
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Apr 1, 1998
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
139123.3 residents per day on average
Chain
Central Management Company21 facilities in the chain

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
19D0464353Forest Haven Nursing & Rehab Center171 Thrasher Drive, Jonesboro, LA 71251Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 26

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

NameRoleSinceShare
Individual Adp of the SNF Apr 7, 2025
Teddy D Price Individual Operational/Managerial Control Mar 1, 2025
Adp of the SNF Mar 1, 2025
Jeffrey Lee Cantrell Individual Adp of the SNF Oct 1, 2013
Holly Maumalanga Individual 5% Or Greater Indirect Ownership Interest Mar 31, 2025 5.64%
Adp of the SNF Mar 31, 2025
Prico, Inc Organization, Winnfield, LA Corporation, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 1998 49%
Adp of the SNF Feb 1, 2001
Teddy R Price Individual 5% Or Greater Indirect Ownership Interest Feb 1, 1998 75.78%
Operational/Managerial ControlManaging Member/Ceo Feb 1, 1998
Adp of the SNF Feb 1, 1998
Individual Adp of the SNF Mar 11, 2025
Individual Adp of the SNF Apr 1, 1998
Central Management Company, LLC Organization, Winnfield, LA LLC, Management services company, Chain home office Operational/Managerial Control Feb 1, 1998 100%
Adp of the SNF Jul 2, 2025
Individual Adp of the SNF Mar 11, 2025
Individual Adp of the SNF Apr 1, 1998
Organization, Lake Charles, LA LLC Adp of the SNF Apr 7, 2025
Individual Adp of the SNF Mar 11, 2025
Individual Adp of the SNF Jan 1, 2010
Organization, Lake Charles, LA LLC, Consulting firm Adp of the SNF Apr 7, 2025
Dawn Rogers Individual Adp of the SNF Apr 1, 1998
Individual Adp of the SNF Jan 1, 2011
Organization, Winnfield, LA LLC Adp of the SNF Jul 2, 2025
Sheila M Bolwahnn Individual Adp of the SNF Dec 1, 2008
James Shelton Individual Adp of the SNF Apr 1, 1998
Individual Adp of the SNF Mar 11, 2025
Kisatchie Health, LLC Organization, Winnfield, LA LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 1998 51%
Adp of the SNF Feb 1, 2001
Individual Adp of the SNF Apr 7, 2025
Organization, Winnfield, LA LLC, Holding company Adp of the SNF Feb 1, 2001
Sandra Billings Individual Adp of the SNF Mar 11, 2025
Freda P Zimmerman Individual 5% Or Greater Indirect Ownership Interest Mar 31, 2025 12.39%
Adp of the SNF Mar 31, 2025

Facilities with the same owner 23

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 23

Practitioners & affiliated clinicians

Practitioners 5

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 4

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": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726099200000",
    "number": "1366423550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 THRASHER DR",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "712514125",
            "telephone_number": "318-259-2729",
            "fax_number": "318-259-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 THRASHER DR",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "712514125",
            "telephone_number": "318-259-2729",
            "fax_number": "318-259-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREST HAVEN NURSING & REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "TEDDY",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "318-628-4116",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "LA",
            "license": "712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1520934",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Forest Haven Nursing & Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jonesboro, LA

Sources for this page

Verify at the official NPI Registry.