Provider Demographics
NPI:1760623235
Name:ACCESSIBLE HOMES LLC
Entity Type:Organization
Organization Name:ACCESSIBLE HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARISA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-978-1054
Mailing Address - Street 1:1104 5TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SOUTH ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55075-3227
Mailing Address - Country:US
Mailing Address - Phone:651-450-5629
Mailing Address - Fax:651-554-3085
Practice Address - Street 1:1104 5TH AVE S
Practice Address - Street 2:
Practice Address - City:SOUTH ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55075-3227
Practice Address - Country:US
Practice Address - Phone:651-450-5629
Practice Address - Fax:651-554-3085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-13
Last Update Date:2009-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNUNPIOtherMEDICAL ASSISTANCE