Active NPI
Odyssey County Home School
- Addiction (Substance Use Disorder) Counselor
- Minnetonka, MN
National Provider Identifier
1912110651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Legal business name
- ODYSSEY COUNTY HOME SCHOOL
- Practice address
- 14300 Cty Rd 62
Minnetonka, MN 55345 - Phone
- (612) 326-7555
- NPI assigned
- May 8, 2007
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | Primary |
Addresses
Primary practice location
14300 Cty Rd 62
Minnetonka, MN 55345
Mailing address
550 Main St
New Brighton, MN 55112-3271
Phone (612) 326-7555
National Provider Directory
National Provider Directory- Tax ID family
- Odyssey County Home School
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Addiction (Substance Use Disorder) Counselor
- Hastings, MN
- NPI 1730393737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1912110651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 MAIN ST",
"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": "612-326-7555"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ODYSSEY COUNTY HOME SCHOOL",
"organizational_subpart": "NO",
"enumeration_date": "2007-05-08",
"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": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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.