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General NPI Number Information
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NPI Number | 1023969904
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Entity Type | Organization
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Legal Business Name | LCDJ ENTERPRISES, LLC
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Dates
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Enumeration Date | 02/05/2026
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Last Update Date | 02/05/2026
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Provider Practice Location Address
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Address Line | 517 VERNON WHITE RD
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City | WINTERVILLE
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State | NC
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Zip | 28590-8691
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Country | US
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Telephone | 252-412-7372
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Fax | 252-412-7372
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Provider Business Mailing Address
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Address Line | 517 VERNON WHITE RD
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City | WINTERVILLE
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State | NC
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Zip | 28590-8691
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Country | US
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Telephone | 252-412-7372
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Fax | 252-412-7372
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MRS. OLIVE W CHAPMAN
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Credential |
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Telephone | 800-691-2290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3104A0630X
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Taxonomy Name | Assisted Living Facility (Behavioral Disturbances)
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License Number |
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License Number State |
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