VILLAGE AT WATERMAN LAKE
NPI 1417164096
Assisted Living Facility in Greenville, RI

Active since May 16, 2007CLIA 41D2195335 · Waiver
715 PUTNAM PIKE, GREENVILLE, RI 02828(401) 949-4333 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Village At Waterman Lake NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VILLAGE AT WATERMAN LAKE (NPI 1417164096) is a healthcare organization registered as an assisted living facility in Greenville, Rhode Island and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through October 7, 2026 and lists Roberta Burley, Contoller, as its authorized official.

NPPES Registry Identity

NPI1417164096
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameVILLAGE AT WATERMAN LAKE
Location Address715 PUTNAM PIKEGreenville, RI 02828-1428
Mailing Address715 Putnam PikeGreenville, RI 02828-1428 · (401) 949-4333
Organization SubpartNo
Authorized OfficialRoberta BurleyContoller · (401) 949-4333
Enumeration DateMay 16, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1417164096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License Licensed in RI · ALR01347
Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

715 PUTNAM PIKE, Greenville, RI 02828

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 41D2195335

Village At Waterman Lake LP, The · Greenville, RI
Active · expires Oct 7, 2026
CLIA Number41D2195335
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 8, 2024
Certificate Expiration DateOctober 7, 2026
Laboratory DirectorOliver Harvey
Laboratory Phone(401) 949-4333
Laboratory LocationVillage At Waterman Lake LP, The715 Putnam Pike, Greenville, RI 02828
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Speech-Language Pathologist
715 PUTNAM PIKE
GREENVILLE, RI 02828
Behavior Analyst
715 PUTNAM PIKE
GREENVILLE, RI 02828
Behavior Analyst
715 PUTNAM PIKE
GREENVILLE, RI 02828
Behavior Analyst
715 PUTNAM PIKE
GREENVILLE, RI 02828
Behavior Analyst
715 PUTNAM PIKE
GREENVILLE, RI 02828
Behavior Analyst
715 PUTNAM PIKE
GREENVILLE, RI 02828
Clinic/Center (Adult Day Care)
715 PUTNAM PIKE, ADULT DAY SERVICE BUILDING
GREENVILLE, RI 02828
Behavior Analyst
715 PUTNAM PIKE
GREENVILLE, RI 02828

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Village At Waterman Lake's NPI number?

The NPI number for Village At Waterman Lake is 1417164096. It was assigned to this organization in the NPPES registry on May 16, 2007.

Where is Village At Waterman Lake located?

Village At Waterman Lake is located at 715 Putnam Pike, Greenville, RI 02828. The listed phone number is (401) 949-4333.

What is Village At Waterman Lake's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Village At Waterman Lake hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 41D2195335) is associated with this NPI, valid through October 7, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Village At Waterman Lake was last updated on August 22, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.