Provider Demographics
NPI:1275740524
Name:ACCESSIBLE SPACE, INC.
Entity Type:Organization
Organization Name:ACCESSIBLE SPACE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDER SCHAAF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-645-7271
Mailing Address - Street 1:2550 UNIVERSITY AVE W
Mailing Address - Street 2:#330N
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1052
Mailing Address - Country:US
Mailing Address - Phone:651-645-7271
Mailing Address - Fax:651-645-0541
Practice Address - Street 1:2550 UNIVERSITY AVE W
Practice Address - Street 2:#330N
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1052
Practice Address - Country:US
Practice Address - Phone:651-645-7271
Practice Address - Fax:651-645-0541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN373890310400000X, 310400000X
385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV9005042146Medicaid
MN12757400524Medicaid
NV9005042146Medicaid
NV9005001662Medicaid
NV9005047905Medicaid