405 RIVER STREET OPERATING COMPANY, LLC
NPI 1609733757
Skilled Nursing Facility in Mattapan, MA
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
Specialties & Licenses
Other Names 1
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, MAOther Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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.