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
14160 NEWBROOK DR STE 100, CHANTILLY, VA 20151-2297
(703) 842-2327
(703) 842-2341
Mailing address
14160 NEWBROOK DR, CHANTILLY, VA 20151-2297
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
0904006376
VA
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004946707
—
VA
Enumeration date
08/03/2006
Last updated
01/09/2018
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