Provider Demographics
NPI:1790491512
Name:CIEDON SERVICES
Entity Type:Organization
Organization Name:CIEDON SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LATARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATISTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-915-5853
Mailing Address - Street 1:5215 COLLEY AVE STE 127
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-2172
Mailing Address - Country:US
Mailing Address - Phone:757-915-5853
Mailing Address - Fax:
Practice Address - Street 1:5215 COLLEY AVE STE 127
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23508-2172
Practice Address - Country:US
Practice Address - Phone:757-915-5853
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-25
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health