Healthcare Provider Details

I. General information

NPI: 1831185255
Provider Name (Legal Business Name): ACCESS TO INDEPENDENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4960 S PROSPECT ST
RAVENNA OH
44266-9016
US

IV. Provider business mailing address

4960 S PROSPECT ST
RAVENNA OH
44266-9016
US

V. Phone/Fax

Practice location:
  • Phone: 330-296-8111
  • Fax: 330-296-0539
Mailing address:
  • Phone: 330-296-8111
  • Fax: 330-296-0539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateOH

VIII. Authorized Official

Name: LYN S WEISS
Title or Position: CEO
Credential:
Phone: 330-296-8111