Organization
COMMUNITY RESIDENCES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY HURLEY (VP ADMIN, CFO)
(703) 842-2321
Entity
Organization
Contact information
Practice address
7477 BALTIMORE ANNAPOLIS BLVD, #202, GLEN BURNIE, MD 21061-3504
(410) 760-2250
Mailing address
14160 NEWBROOK DR, CHANTILLY, VA 20151-2297
(703) 842-2333
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5051 MH-719
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4215613 00
—
MD
Enumeration date
04/30/2013
Last updated
01/09/2018
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