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Organization

COMMUNITY RESIDENCES, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TERRY HURLEY (VP OF ADMINISTRATION/CFO)
(703) 842-2321
Entity
Organization

Contact information

Practice address
14160 NEWBROOK DR, CHANTILLY, VA 20151-2297
(703) 842-2333
(703) 842-2311
Mailing address
14160 NEWBROOK DR, CHANTILLY, VA 20151-2297
(703) 842-2333
(703) 842-2311

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
05801001, 05801003,
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004946138
VA
Enumeration date
10/25/2006
Last updated
01/09/2018
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