OrganizationActive
Community Residences, Inc.
NPI 1922184282 · Intellectual Disabilities Intermediate Care Facility · Arlington, VA
Provider details
- NPI number
- 1922184282
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Mary Jayne Panek, Project Implementation Manager(703) 842-2327
- License
- 05801001 (VA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
1612 N Mckinley Rd
Arlington, VA 22205-2237
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.