Provider Demographics
NPI:1568180693
Name:ROSE HAVEN AT MERRIMACK
Entity Type:Organization
Organization Name:ROSE HAVEN AT MERRIMACK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-930-8123
Mailing Address - Street 1:8 JENNIFER DR
Mailing Address - Street 2:
Mailing Address - City:MERRIMACK
Mailing Address - State:NH
Mailing Address - Zip Code:03054-4411
Mailing Address - Country:US
Mailing Address - Phone:603-424-5919
Mailing Address - Fax:603-424-5920
Practice Address - Street 1:8 JENNIFER DR
Practice Address - Street 2:
Practice Address - City:MERRIMACK
Practice Address - State:NH
Practice Address - Zip Code:03054-4411
Practice Address - Country:US
Practice Address - Phone:603-424-5919
Practice Address - Fax:603-424-5920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Single Specialty