Provider Demographics
NPI:1891320602
Name:CIONE MCQUEEN RESIDENCES, LLC
Entity Type:Organization
Organization Name:CIONE MCQUEEN RESIDENCES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CIONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-949-2204
Mailing Address - Street 1:208 CARDINAL CT
Mailing Address - Street 2:
Mailing Address - City:STANARDSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22973-2902
Mailing Address - Country:US
Mailing Address - Phone:716-949-2204
Mailing Address - Fax:
Practice Address - Street 1:208 CARDINAL CT
Practice Address - Street 2:
Practice Address - City:STANARDSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22973-2902
Practice Address - Country:US
Practice Address - Phone:716-949-2204
Practice Address - Fax:434-381-4294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA3512Medicaid