Organization
ODYSSEY JUVENILE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE BUNDY (CONTROLLER)
(612) 326-7555
Entity
Organization
Contact information
Practice address
1600 CTY RD 55, HASTINGS, MN 55003
(612) 326-7555
Mailing address
550 MAIN ST, NEW BRIGHTON, MN 55112-3271
(612) 326-7555
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1023927
MN
Other
Enumeration date
05/09/2007
Last updated
08/22/2020
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