NPIMap

Organization Active NPI

Community Residences, Inc.

  • Community/Behavioral Health Agency
  • Glen Burnie, MD
National Provider Identifier
1609211002
Registry record updated Jan 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
5051 MH-719 Issued in MD
Legal business name
COMMUNITY RESIDENCES, INC.
Practice address
7477 Baltimore Annapolis Blvd
#202
Glen Burnie, MD 21061-3504
Phone
(410) 760-2250
NPI assigned
Apr 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2018

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

Authorized official

Name
Terry Hurley
Title
VP Admin, Cfo
Phone
(703) 842-2321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 5051 MH-719 MD Primary

Addresses

Primary practice location

7477 Baltimore Annapolis Blvd
#202
Glen Burnie, MD 21061-3504

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
4215613 00MedicaidMD

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

Locations

7477 Baltimore Annapolis Blvd
Ste 202
Glen Burnie, MD 21061
Phone (410) 760-2250

NPI Registry JSON

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515456000000",
    "number": "1609211002",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7477 BALTIMORE ANNAPOLIS BLVD",
            "address_2": "#202",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613504",
            "telephone_number": "410-760-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY RESIDENCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2018-01-09",
        "status": "A",
        "authorized_official_last_name": "HURLEY",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "VP ADMIN, CFO",
        "authorized_official_telephone_number": "703-842-2321"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "5051  MH-719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4215613 00",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.