Provider Demographics
NPI:1346837309
Name:ACCESS SUPPORTIVE AERVICES, INC
Entity Type:Organization
Organization Name:ACCESS SUPPORTIVE AERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:TEMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-983-7165
Mailing Address - Street 1:688 BROADWAY AVE # 5
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-3672
Mailing Address - Country:US
Mailing Address - Phone:440-983-7165
Mailing Address - Fax:
Practice Address - Street 1:688 BROADWAY AVE # 5
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-3672
Practice Address - Country:US
Practice Address - Phone:440-983-7165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2900875Medicaid