The Waterford Group, Inc.

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALF183 Issued in NE

Legal business name

THE WATERFORD GROUP, INC.

Practice address

3940 Pine Lake Rd
Lincoln, NE 68516-5485

Phone

(402) 423-0000

Fax

(402) 423-1601

NPI assigned

Dec 16, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dan A. Klein Sr.

Title

Owner

Phone

(402) 435-3550

Specialties & licenses 1

Addresses

Other names 1

• The Waterford at Williamsburg Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292457600000",
    "number": "1164725958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 SW 5TH ST",
            "address_2": "SUITE 100",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685221754",
            "telephone_number": "402-435-3550",
            "fax_number": "402-435-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3940 PINE LAKE RD",
            "city": "LINCOLN",
            "state": "NE",
            "postal_code": "685165485",
            "telephone_number": "402-423-0000",
            "fax_number": "402-423-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WATERFORD GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-16",
        "last_updated": "2010-12-16",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-435-3550",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NE",
            "license": "ALF183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Waterford at Williamsburg",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Assisted Living Facility in Lincoln, NE
• Providers in Lincoln, NE by specialty
• Assisted Living Facility in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.