Dontrieze Kenyatta Chapman

Individual provider Active NPI Mental Illness Community Based Residential Treatment Facility · Kinston, NC

NPI 1508672197 · NPPES record last updated Feb 4, 2025

Key facts

NPI
1508672197
Entity type
Individual (NPI type 1)
Primary specialty
Mental Illness Community Based Residential Treatment Facility 320800000X
Practice address
2105 Presbyterian LN
Kinston, NC 28501-2265
Phone
(252) 268-3798
Fax
(252) 509-0455
NPI assigned
Dec 9, 2024
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Prestigious Living, LLC Community Based Residential Treatment Facility, Mental Illness Current Accepting new patients

Locations

2105 Presbyterian Ln
Kinston, NC 28501
Phone (252) 268-3798

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Mental Illness Community Based Residential Treatment Facility 320800000X Yes

Addresses

Primary practice location

2105 Presbyterian LN
Kinston, NC 28501-2265

Mailing address

2105 Presbyterian LN
Kinston, NC 28501-2265
Phone (252) 268-3798

Other providers in Kinston, NC

All providers in Kinston, NC · Mental Illness Community Based Residential Treatment Facility in North Carolina

Sources for this page

Verify at the official NPI Registry.