OrganizationActive
Community Residences, Inc.
NPI 1922415934 · Intellectual Disabilities Intermediate Care Facility · Burke, VA
Provider details
- NPI number
- 1922415934
- Entity type
- Organization
- Primary specialty
- Intellectual Disabilities Intermediate Care FacilityNursing & Custodial Care Facilities
- Authorized official
- Terry Hurley, V.p., Cfo
- License
- 058-01-005 (VA)
Mailing address
14160 Newbrook Dr
Chantilly, VA 20151-2297
Registry dates
- Enumerated
- 2014-07-22
- 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.