OrganizationActive
Community Residences, Inc.
NPI 1487730743 · Intellectual Disabilities Intermediate Care Facility · Richmond, VA
Provider details
- NPI number
- 1487730743
- 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
Practice location
4213 Reservoir Ln
Richmond, VA 23234-3534
Phone: (703) 842-2333
Fax: (703) 842-2311
Approximate (ZIP-level) locationGet directions
Mailing address
14160 Newbrook Dr
Chantilly, VA 20151-2297
Registry dates
- Enumerated
- 2006-10-30
- 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.