MEDICARE: TEMPLE HEALTHCARE AGENCY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1275125064
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEMPLE HEALTHCARE AGENCY LLC

Provider Business Mailing Address
First Line	:	1639 S MERIDIAN AVE STE 6
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67213-1941
Country	:	US
Telephone Number	:	316-869-6775
Fax Number	:

Provider Business Practice Location Address
First Line	:	1639 S MERIDIAN AVE STE 6
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67213-1941
Country	:	US
Telephone Number	:	316-869-6775
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO/LPN
Name	:	LAQUISHA Q TEMPLE
Credential	:	LPN
Telephone Number	:	316-803-3341

Provider Enumeration Date	:	02/03/2021
Last Update Date	:	02/18/2023

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Directions to “TEMPLE HEALTHCARE AGENCY LLC ” Practice Location

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