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Organization
BLACK HILLS BEHAVIOR, LLC
Active
Organization
BLACK HILLS BEHAVIOR, LLC
Active
Other names
Impact Learning & Development
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY L PRUITT MS, BCBA, LBA (OWNER)
(605) 206-5004
Entity
Organization
Contact information
Practice address
621 N CREEK DR, RAPID CITY, SD 57703-2222
(605) 206-5004
(605) 646-4840
Mailing address
621 N CREEK DR, RAPID CITY, SD 57703-2222
(605) 206-5004
(605) 646-4840
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
106E00000X
Assistant Behavior Analyst
—
—
106S00000X
Behavior Technician
—
—
225100000X
Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225X00000X
Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
10/06/2018
Last updated
08/18/2024
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