Provider Demographics
NPI:1508484734
Name:ACCESSIBLE SPACE INC.
Entity Type:Organization
Organization Name:ACCESSIBLE SPACE INC.
Other - Org Name:
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 W CHARLESTON BLVD BLDG L
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-1139
Mailing Address - Country:US
Mailing Address - Phone:702-259-1903
Mailing Address - Fax:
Practice Address - Street 1:1405 SOUTH MOJAVE RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89104
Practice Address - Country:US
Practice Address - Phone:702-434-0067
Practice Address - Fax:702-434-1490
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCESSIBLE SPACE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities