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General NPI Number Information
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NPI Number | 1922818947
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Entity Type | Organization
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Legal Business Name | THE NEW TEMPLE
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Dates
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Enumeration Date | 01/11/2025
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Last Update Date | 09/13/2025
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Provider Practice Location Address
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Address Line | 2622 VIRGINIA AVE
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City | LOUISVILLE
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State | KY
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Zip | 40211-3415
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Country | US
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Telephone | 502-819-1631
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Fax |
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Provider Business Mailing Address
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Address Line | 2620 VIRGINIA AVE
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City | LOUISVILLE
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State | KY
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Zip | 40211-3415
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Country | US
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Telephone | 502-819-1631
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DYNEESHA TEMPLE
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Credential |
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Telephone | 502-302-2567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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