NPIMap

Organization Active NPI

Community Residences, Inc.

  • Intellectual Disabilities Intermediate Care Facility
  • Ashburn, VA
National Provider Identifier
1497044267
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
COMMUNITY RESIDENCES, INC.
Practice address
22755 Sweet Andrea Drive
Cri - Brambleton Icf
Ashburn, VA 20148
Phone
(703) 842-2333
Fax
(703) 842-2341
NPI assigned
Apr 1, 2011
Last updated
Apr 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Terence Hurley
Title
V.P., Cfo
Phone
(703) 842-2321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X VA Primary

Addresses

Primary practice location

22755 Sweet Andrea Drive
Cri - Brambleton Icf
Ashburn, VA 20148

Mailing address

14160 Newbrook Dr
Chantilly, VA 20151-2297
Phone (703) 842-2333

Other names 1

  • Brambleton ICF Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1497044267. Details of each certification follow.

  • CCN 49G052 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 49G052

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BRAMBLETON GROUP HOME
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jul 14, 2011
Last certification
Oct 13, 2023
Beds
6
Ownership / control type
County
Facility address
22755 Sweet Andrea Drive
Ashburn, VA 20148

National Provider Directory

National Provider Directory
Tax ID family
Community Residences Inc24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1497044267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14160 NEWBROOK DR",
            "city": "CHANTILLY",
            "state": "VA",
            "postal_code": "201512297",
            "telephone_number": "703-842-2333",
            "fax_number": "703-842-2341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22755 SWEET ANDREA DRIVE",
            "address_2": "CRI - BRAMBLETON ICF",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "20148",
            "telephone_number": "703-842-2333",
            "fax_number": "703-842-2341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RESIDENCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "HURLEY",
        "authorized_official_first_name": "TERENCE",
        "authorized_official_title_or_position": "V.P., CFO",
        "authorized_official_telephone_number": "703-842-2321"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brambleton ICF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Ashburn, VA

Sources for this page

Verify at the official NPI Registry.