Provider Demographics
NPI:1902008477
Name:ODIN HS 700
Entity Type:Organization
Organization Name:ODIN HS 700
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:RENCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-532-4721
Mailing Address - Street 1:100 MERRITT
Mailing Address - Street 2:
Mailing Address - City:ODIN
Mailing Address - State:IL
Mailing Address - Zip Code:62870-0250
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 MERRITT
Practice Address - Street 2:
Practice Address - City:ODIN
Practice Address - State:IL
Practice Address - Zip Code:62870-0250
Practice Address - Country:US
Practice Address - Phone:618-532-4721
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)