Provider Demographics
NPI:1417023458
Name:ACCEND SERVICES INCORPORATED
Entity type:Organization
Organization Name:ACCEND SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CLEVETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:218-391-7129
Mailing Address - Street 1:101 W 2ND ST STE 200
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-5004
Mailing Address - Country:US
Mailing Address - Phone:218-724-3122
Mailing Address - Fax:833-933-0639
Practice Address - Street 1:101 W 2ND ST STE 200
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-5004
Practice Address - Country:US
Practice Address - Phone:218-724-3122
Practice Address - Fax:833-933-0639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 251S00000X, 261QM0850X, 261QM0855X
MN06443251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN423264000OtherDHS ARMHS PROVIDER NUMBER