Healthcare Provider Details

I. General information

NPI: 1598483398
Provider Name (Legal Business Name): ACCESSIBLE SPACE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2022
Last Update Date: 08/23/2022
Certification Date: 08/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6375 W CHARLESTON BLVD BLDG L
LAS VEGAS NV
89146-1139
US

IV. Provider business mailing address

6375 W CHARLESTON BLVD BLDG L
LAS VEGAS NV
89146-1139
US

V. Phone/Fax

Practice location:
  • Phone: 702-259-1903
  • Fax:
Mailing address:
  • Phone: 702-259-1903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JERRY KAPPELER
Title or Position: DIRECTOR
Credential:
Phone: 702-587-2867