MEDICARE: ACCESSIBLE SPACE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0400X	Rehabilitation Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053531459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESSIBLE SPACE INC.

Provider Business Mailing Address
First Line	:	6375 WEST CHARLESTON BLVD.
Second Line	:	SUITE L200 WCL
City	:	LAS VEGAS
State	:	NV
Zip	:	89146
Country	:	US
Telephone Number	:	702-259-1903
Fax Number	:	702-259-1907

Provider Business Practice Location Address
First Line	:	6375 WEST CHARLESTON BLVD.
Second Line	:	SUITE L200 WCL
City	:	LAS VEGAS
State	:	NV
Zip	:	89146
Country	:	US
Telephone Number	:	702-259-1903
Fax Number	:	702-259-1907

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JERRY KAPPELER
Credential	:
Telephone Number	:	702-259-1903

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	07/14/2020

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Directions to “ACCESSIBLE SPACE INC. ” Practice Location

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