405 RIVER STREET OPERATING COMPANY, LLC
NPI 1609733757
Skilled Nursing Facility in Mattapan, MA

Active since January 08, 2026CLIA 22D2191849 · Waiver
405 RIVER ST, MATTAPAN, MA 02126(617) 296-5585 Get Directions Write a Review

NPPES record last updated: April 15, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 15, 2026, Jan 8, 2026 (2 updates tracked since 2026).

About 405 River Street Operating Company, Llc NPPES

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

405 RIVER STREET OPERATING COMPANY, LLC (NPI 1609733757), doing business as Care Village At Mattapan, is a healthcare organization registered as a skilled nursing facility in Mattapan, Massachusetts and active in the NPI registry since January 2026. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Jeffrey Rubin, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1609733757
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business Name405 RIVER STREET OPERATING COMPANY, LLC
Location Address405 RIVER STMattapan, MA 02126-2210
Mailing Address405 River StMattapan, MA 02126-2210 · (617) 296-5585
Organization SubpartNo
Authorized OfficialJeffrey RubinAuthorized Official · (516) 413-6321
Enumeration DateJanuary 8, 2026
Last NPPES UpdateApril 15, 20262 updates tracked since enumeration
NPPES CertifiedApril 15, 2026
NPI 1609733757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
405 RIVER ST, Mattapan, MA 02126

Other Names 1

Doing Business AsCare Village At Mattapan

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 22D2191849

405 River Street Operating Company LLC Dba Care Village At Mattapan · Mattapan, MA
Active · expires Aug 31, 2026
CLIA Number22D2191849
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorAlireza Toossi
Laboratory Phone(617) 296-5585
Laboratory Location405 River Street Operating Company LLC Dba Care Village At Mattapan405 River Street, Mattapan, MA 02126
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 3

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

Skilled Nursing Facility
405 RIVER ST
MATTAPAN, MA 02126
Skilled Nursing Facility
405 RIVER ST
MATTAPAN, MA 02126
Skilled Nursing Facility
405 RIVER ST
MATTAPAN, MA 02126

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 405 River Street Operating Company, LLC's NPI number?

The NPI number for 405 River Street Operating Company, LLC is 1609733757. It was assigned to this organization in the NPPES registry on January 8, 2026. The provider is doing business as Care Village at Mattapan.

Where is 405 River Street Operating Company, LLC located?

405 River Street Operating Company, LLC is located at 405 River St, Mattapan, MA 02126. The listed phone number is (617) 296-5585.

What is 405 River Street Operating Company, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does 405 River Street Operating Company, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2191849) is associated with this NPI, valid through August 31, 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 405 River Street Operating Company, LLC was last updated on April 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.