Provider Demographics
NPI:1053531459
Name:ACCESSIBLE SPACE INC.
Entity type:Organization
Organization Name:ACCESSIBLE SPACE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPPELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-259-1903
Mailing Address - Street 1:6375 WEST CHARLESTON BLVD.
Mailing Address - Street 2:SUITE L200 WCL
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146
Mailing Address - Country:US
Mailing Address - Phone:702-259-1903
Mailing Address - Fax:702-259-1907
Practice Address - Street 1:6375 WEST CHARLESTON BLVD.
Practice Address - Street 2:SUITE L200 WCL
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146
Practice Address - Country:US
Practice Address - Phone:702-259-1903
Practice Address - Fax:702-259-1907
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCESSIBLE SPACE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-26
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV005502006Medicaid