NPIMap

Organization Active NPI

Odyssey Programs, LLC

Doing business as Odyssey - County Home School

  • Addiction (Substance Use Disorder) Counselor
  • Minnetonka, MN
National Provider Identifier
1265556203
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1020218 Issued in MN
Legal business name
ODYSSEY PROGRAMS, LLC
Doing business as
Odyssey - County Home School
Practice address
14300 Cty Rd 62
Minnetonka, MN 55345
Phone
(612) 596-0530
NPI assigned
Mar 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Valerie Bundy
Title
Controller
Phone
(612) 326-7555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1020218 MN Primary

Addresses

Primary practice location

14300 Cty Rd 62
Minnetonka, MN 55345

Mailing address

550 Main St
Ste 230
New Brighton, MN 55112-3271
Phone (612) 326-7555

Other names 1

  • Odyssey - County Home School Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Odyssey - County Home School4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14300 County Road 62
Minnetonka, MN 55345
Phone (320) 532-4005

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265556203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 MAIN ST",
            "address_2": "STE 230",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551123271",
            "telephone_number": "612-326-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14300 CTY RD 62",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55345",
            "telephone_number": "612-596-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ODYSSEY PROGRAMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUNDY",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "612-326-7555"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MN",
            "license": "1020218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Odyssey - County Home School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.