Provider Demographics
NPI:1447017884
Name:HAYTEMPLE LLC
Entity type:Organization
Organization Name:HAYTEMPLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MONSUNMOLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEWALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-504-5618
Mailing Address - Street 1:509 PRESTON PARK DR # 509
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-8817
Mailing Address - Country:US
Mailing Address - Phone:470-504-5618
Mailing Address - Fax:
Practice Address - Street 1:509 PRESTON PARK DR # 509
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-8817
Practice Address - Country:US
Practice Address - Phone:470-504-5618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:-
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-03-04
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health