COMMUNITY RESIDENCES, INC (NPI# 1396820098) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396820098 |
| Entity Type | Organization |
| Organization Name | COMMUNITY RESIDENCES, INC |
| Practice Address |
14160 Newbrook Dr Chantilly VA 20151-2297 |
| Practice Telephone | 7038422333 |
| Practice Fax Number | 7038422311 |
| Mailing Telephone | 7038422333 |
| Mailing Fax Number | 7038422311 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2018-01-09 |
| Authorized Official Name | MR. TERRY HURLEY (VP OF ADMINISTRATION/CFO) |
| Authorized Official Telephone | 7038422321 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
05801001, 058010 | VA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 004946138 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972675908 | Community Residences, Inc | Intermediate Care Facility, Mentally Retarded | 807 North Jackson Street, Cri Jackson Street Icf, Arlington, VA 22201 | 2006-11-14 |
| 1942218565 | Community Residences, Inc | Social Worker | 14160 Newbrook Dr Ste 100, Chantilly, VA 20151-2297 | 2006-08-03 |
| 1588062830 | Community Residences, Inc | Community/Behavioral Health | 7477 Baltimore Annapolis Blvd, Suite 203, Glen Burnie, MD 21061-3504 | 2014-12-18 |
| Street Address |
14160 NEWBROOK DR |
| City | CHANTILLY |
| State | VA |
| Zip Code | 20151-2297 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720562481 | Ricky Yates | Social Worker | 14160 Newbrook Dr, Chantilly, VA 20151-2297 | 2018-09-19 |
| 1669920955 | Community Residences, Inc. | In Home Supportive Care | 14160 Newbrook Dr, Suite 100, Chantilly, VA 20151-2297 | 2016-09-14 |
| 1417246174 | Community Residences, Inc. | Day Training, Developmentally Disabled Services | 14160 Newbrook Dr, Chantilly, VA 20151-2297 | 2011-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023635695 | Sabah Home Care | Home Health | 4221 Walney Rd Suite 500 C, Chantilly, VA 20151 | 2020-06-30 |
| 1205485976 | Huang Wellness Center LLC | Acupuncturist | 14145 Robet Paris Ct, Chantilly, VA 20151 | 2019-09-05 |
| 1376032714 | Myeyedr Optometry of Virginia, Pllc | Optometrist | 14337 Newbrook Drive, Suite 400, Chantilly, VA 20151 | 2018-05-01 |
| 1013405950 | Chantilly Modern Dentistry, PC | Dentist | 14337 Newbrook Dr., Suite 200, Chantilly, VA 20151 | 2018-04-26 |
| 1972090389 | Wegmans Food Markets, Inc. | Pharmacy | 14361 Newbrook Dr., Chantilly, VA 20151 | 2018-04-20 |
| 1922526714 | Cynthia Anne Biggar | Specialist/Technologist | 13613 Bare Island Drive, Chantilly, VA 20151 | 2017-09-01 |
| 1497297717 | Rebekah Lee Hinders | Nurse Practitioner | 3914 Centrevill Rd, Suite 101, Chantilly, VA 20151 | 2016-11-17 |
| 1043761117 | Victoria Ranti Balogun | Nurse Practitioner | 14121 Parke Long Court, Suite 201, Chantilly, VA 20151 | 2016-10-24 |
| 1619424694 | Erin Booker | Nurse Practitioner | Parke Long Court, Suite 201, Chantilly, VA 20151 | 2016-09-07 |
| 1326419078 | Amparo Emilia Kidd | Nurse Practitioner | 14121 Parke Long Court, Suite 201, Chantilly, VA 20151 | 2015-10-07 |
| Find all providers in zip 20151 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629339700 | Quality Home Care Services,inc | Custodial Care Facility | 4834 Autumn Glory Way, Chantilly, VA 20151-2352 | 2012-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627070 | Home & Heart LLC | Custodial Care Facility | 317 Bullock St, Suffolk, VA 23434-3109 | 2020-10-21 |
| 1477160778 | Able Arms | Custodial Care Facility | 312 Loudon St, Lynchburg, VA 24503-2832 | 2020-09-30 |
| 1073120242 | Peace In Life, LLC. | Custodial Care Facility | 3101 American Legion Road 21a, Chesapeake, VA 23321 | 2020-09-30 |
| 1568076719 | Care First Resident Services, LLC | Custodial Care Facility | 8813 Cather Ave, Manassas, VA 20110-6105 | 2020-09-04 |
| 1174157861 | Andrea's Caring Corner, LLC | Custodial Care Facility | 703 Argyle St, Portsmouth, VA 23704-6611 | 2020-03-03 |
| 1184262602 | Hagir Hassan Suliman Eldmiyati | Custodial Care Facility | 1916 N Parham Rd, Richmond, VA 23229-4023 | 2019-12-16 |
| 1073160578 | All People Home LLC | Custodial Care Facility | 8213 Calm Pond Ct, Manassas Park, VA 20111-2343 | 2019-08-20 |
| 1033693395 | Daniels Residential Living | Custodial Care Facility | 315 W Constance Rd # 252, Suffolk, VA 23434-4968 | 2018-09-21 |
| 1063964831 | Caring Hands Healthcare Inc | Custodial Care Facility | 6223 Greeley Blvd, Springfield, VA 22152-1941 | 2016-10-27 |
| 1376092502 | Anab Jibril | Custodial Care Facility | 11249 Kessler Pl, Manassas, VA 20109-7778 | 2016-09-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.