OrganizationActive
Community Residences, Inc.
NPI 1164506861 · Intellectual Disabilities Intermediate Care Facility · Manassas, VA
Provider details
- NPI number
- 1164506861
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Terry Hurley, Vp Admin, Cfo(703) 842-2321
- License
- 05801003 (VA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10144 Lake Jackson Dr
Manassas, VA 20111-2832
Phone: (703) 842-2333
Fax: (703) 842-2311
Street-level locationGet directions
Mailing address
14160 Newbrook Dr
Chantilly, VA 20151-2297
Registry dates
- Enumerated
- 2006-10-25
- Last updated
- 2018-01-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.