# MARK H. WENTWORTH HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518013622
- **Authorized official:** DEBORAH RODIER RN (ADMINISTRATOR)
- **Authorized official phone:** (603) 436-0169

## Contact information

- **Practice address:** 346 PLEASANT ST, PORTSMOUTH, NH 03801-4536
- **Practice address phone:** (603) 436-0169
- **Mailing address:** 346 PLEASANT ST, PORTSMOUTH, NH 03801-4536
- **Mailing address phone:** (603) 436-0169

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 00147 | NH | Yes |

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 08/06/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 30003658 | — | NH |