COMMUNITY RESIDENCES, INC (NPI# 1972675908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972675908 |
| Entity Type | Organization |
| Organization Name | COMMUNITY RESIDENCES, INC |
| Practice Address |
807 North Jackson Street Cri Jackson Street Icf Arlington VA 22201 |
| Mailing Address |
14160 Newbrook Dr Chantilly VA 20151-2297 |
| Practice Telephone | 7038422333 |
| Mailing Telephone | 7038422333 |
| Mailing Fax Number | 7038422311 |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2018-01-09 |
| Authorized Official Name | TERRY WILLIAM HURLEY (VP OF ADMINISTRATION/CFO) |
| Authorized Official Telephone | 7038422321 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 05801001 | VA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 010144833 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396820098 | Community Residences, Inc | Custodial Care Facility | 14160 Newbrook Dr, Chantilly, VA 20151-2297 | 2006-10-25 |
| 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 |
807 NORTH JACKSON STREET CRI JACKSON STREET ICF |
| City | ARLINGTON |
| State | VA |
| Zip Code | 22201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801314422 | Michael John Harrington | Specialist/Technologist | 1301 N Stafford St, Arlington, VA 22201 | 2017-09-04 |
| 1376083352 | Life We Deserve, LLC | Community/Behavioral Health | 1919 Clarendon Blvd Apt 538, Arlington, VA 22201 | 2017-02-24 |
| 1821471244 | Christopher P Henry | Dentist | 1025 N. Fillmore St., Suite A, Arlington, VA 22201 | 2015-07-02 |
| 1699174714 | Northstar Psychological Services | Psychologist | 2000 N. 15th Street, Suite G2-100, Arlington, VA 22201 | 2014-08-14 |
| 1861823809 | Nicole Aniela Szwanke | Physical Therapist | 1005 N Glebe Rd Ste 410, Arlington, VA 22201 | 2013-12-02 |
| 1285073791 | Live Longer Labs LLC | Clinical Medical Laboratory | 1040 N Quincy St Suite 500, Arlington, VA 22201 | 2013-06-18 |
| 1992093355 | Deepthi Moola | Student in an Organized Health Care Education/Training Program | 1005 North Glebe Rd, #430, Arlington, VA 22201 | 2011-07-19 |
| 1245527886 | Eva K Swenson | Dentist | 2250 Clarendon Blvd. Apt. 1212, Arlington, VA 22201 | 2011-07-04 |
| 1639483951 | Hooman Hamidi | Chiropractor | 2778 Washington Blvd, Arlington, VA 22201 | 2010-07-28 |
| 1831400233 | Stephanie A Klassner | Dentist | 1025 North Fillmore Street, Suite A, Arlington, VA 22201 | 2010-06-30 |
| Find all providers in zip 22201 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952773053 | West Tennessee Community Homes | Intermediate Care Facility, Mentally Retarded | 11003 Highway 70, Arlington, TN 38002 | 2015-10-28 |
| 1124490222 | West Tennessee Community Homes | Intermediate Care Facility, Mentally Retarded | 11443 Arlington Woods Cove, Arlington, TN 38002 | 2015-10-28 |
| 1245602341 | West Tennessee Community Homes | Intermediate Care Facility, Mentally Retarded | 11455 Arlington Woods Cove, Arlington, TN 38002 | 2015-10-28 |
| 1063884153 | West Tennessee Community Homes | Intermediate Care Facility, Mentally Retarded | 11456 Arlington Woods Cove, Arlington, TN 38002 | 2015-10-28 |
| 1205208543 | West Tennessee Community Homes | Intermediate Care Facility, Mentally Retarded | 10926 Luboc Road, Arlington, TN 38002 | 2015-10-27 |
| 1568834802 | West Tennessee Community Homes | Intermediate Care Facility, Mentally Retarded | 11005 Highway 70, Arlington, TN 38002 | 2015-10-27 |
| 1265804470 | West Tennessee Community Homes | Intermediate Care Facility, Mentally Retarded | 95 Oak Hill Lane, Arlington, TN 38002 | 2015-10-27 |
| 1992177638 | West Tennessee Community Homes | Intermediate Care Facility, Mentally Retarded | 5982 Polk Street, Arlington, TN 38002 | 2015-10-21 |
| 1295107944 | West Tennessee Community Homes | Intermediate Care Facility, Mentally Retarded | 7405 Osborntown Road, Arlington, TN 38002 | 2015-10-21 |
| 1659743300 | West Tennessee Community Homes | Intermediate Care Facility, Mentally Retarded | 11444 Arlington Woods Cove, Arlington, TN 38002 | 2015-10-21 |
| Find all providers in ARLINGTON | ||||
Please comment or provide details below to improve the information on COMMUNITY RESIDENCES, INC.
| 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.