Healthcare Provider Details

I. General information

NPI: 1710233762
Provider Name (Legal Business Name): ACCELERATE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2012
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1908 W 42ND ST SUITE B
SIOUX FALLS SD
57105-6291
US

IV. Provider business mailing address

1908 W 42ND ST SUITE B
SIOUX FALLS SD
57105-6291
US

V. Phone/Fax

Practice location:
  • Phone: 605-351-7976
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number0323
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: PAUL GRAUMANN
Title or Position: CO-PRESIDENT
Credential:
Phone: 605-351-7976