Provider Demographics
NPI:1770338758
Name:OBAKAYE TEMPLE
Entity type:Organization
Organization Name:OBAKAYE TEMPLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OLUWO/EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IFAKOLADE
Authorized Official - Middle Name:ODI
Authorized Official - Last Name:REECE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-371-3823
Mailing Address - Street 1:5070 VEGAS VALLEY DR UNIT 621804
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89162-8882
Mailing Address - Country:US
Mailing Address - Phone:702-371-3823
Mailing Address - Fax:
Practice Address - Street 1:5070 VEGAS VALLEY DR UNIT 621804
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89162-8882
Practice Address - Country:US
Practice Address - Phone:702-371-3823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-22
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoralGroup - Multi-Specialty
No374K00000XNursing Service Related ProvidersReligious Nonmedical PractitionerGroup - Multi-Specialty