| Community Residences, Inc. | |
|
7477 Baltimore Annapolis Blvd #202 Glen Burnie MD 21061-3504 | |
| (410) 760-2250 | |
| Not Available |
| Full Name | Community Residences, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 7477 Baltimore Annapolis Blvd, Glen Burnie, Maryland |
| Authorized Official Name and Position | Terry Hurley (VP ADMIN, CFO) |
| Authorized Official Contact | 7038422321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Residences, Inc. 14160 Newbrook Dr Chantilly VA 20151-2297 Ph: (703) 842-2333 | Community Residences, Inc. 7477 Baltimore Annapolis Blvd #202 Glen Burnie MD 21061-3504 Ph: (410) 760-2250 |
| NPI Number | 1609211002 |
|---|---|
| Provider Enumeration Date | 04/30/2013 |
| Last Update Date | 01/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609211002 | NPI | - | NPPES |
| 4215613 00 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 5051 MH-719 (Maryland) | Primary |
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