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Community Residences, Inc.
Intellectual Disabilities Intermediate Care Facility in Manassas, Virginia
NPI 1164506861

Community Residences, Inc. is a Intellectual Disabilities Intermediate Care Facility based in Chantilly, VA. Community Residences, Inc. practices in Manassas, VA. The NPI Number for Community Residences, Inc. is 1164506861 and holds a License No. 05801003 (Virginia).

The current practice location address for Community Residences, Inc. is 10144 Lake Jackson Dr, Manassas, VA and can be reached out via phone at 703-842-2333 and via fax at 703-842-2311.

Location: 10144 Lake Jackson Dr, Manassas, VA, 20151-2297
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1164506861
Provider Name
Community Residences, Inc.
Credential
Provider Entity Type
Organization
Address
10144 Lake Jackson Dr, Manassas, VA, 20151-2297
Phone Number
703-842-2333
Fax Number
703-842-2311
Provider Enumeration Date
10/25/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004960823 05 VA
institution
Provider Business Practice Location Address Details
Address
10144 Lake Jackson Dr
City
Manassas
State
Virginia
Zip
20111-2832
Phone Number
703-842-2333
Fax Number
703-842-2311
person
Provider Business Mailing Address Details
Address
10144 Lake Jackson Dr
City
Manassas
State
Virginia
Zip
20111-2832
Phone Number
703-842-2333
Fax Number
703-842-2311
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Intermediate Care Facility, Mentally Retarded
Speciality
-
Taxonomy
315P00000X
License No.
05801003 (Virginia)
Definition
(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.
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