| NPI | 1649672536 |
|---|---|
| Other Name | TEMPLE CLASS CMA |
| Entity Type | Organization |
| Authorized Contact | ANGIE MATTINGLY Mgr Provider Enrollment 502-630-7425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2023-10-18 |