| October Road Inc | |
|
255 Williamsburg Pkwy Jacksonville NC 28546-6856 | |
| (828) 606-9013 | |
| Not Available |
| Full Name | October Road Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 255 Williamsburg Pkwy, Jacksonville, North Carolina |
| Authorized Official Name and Position | Jason Hendricks (CEO) |
| Authorized Official Contact | 8149400407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| October Road Inc Po Box 967 Duncansville PA 16635-0967 Ph: (814) 940-0407 | October Road Inc 255 Williamsburg Pkwy Jacksonville NC 28546-6856 Ph: (828) 606-9013 |
| NPI Number | 1376389940 |
|---|---|
| Provider Enumeration Date | 07/03/2024 |
| Last Update Date | 04/04/2025 |
| Certification Date | 04/04/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376389940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Secondary |
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