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Organization

OCTOBER ROAD INC.

Active
Find providers by NPI
Organization

OCTOBER ROAD INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JASON HENDRICKS (CHIEF EXECUTIVE OFFICER)
(814) 940-0407
Entity
Organization

Contact information

Practice address
119 TUNNEL RD STE B, ASHEVILLE, NC 28805-1800
(828) 350-1000
(828) 350-1300
Mailing address
119 TUNNEL RD, SUITE D, ASHEVILLE, NC 28805-1869
(828) 350-1000
(828) 350-1300

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
MLH-011-272
NC
251S00000X
Community/Behavioral Health Agency
Primary
—
—

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3410004
—
NC
05
—
5905845
—
NC
05
—
6006159
—
NC
05
—
8305312
—
NC
05
—
8703016
—
NC
01
—
MHL-011-272
NC DHSR
—
Enumeration date
01/24/2007
Last updated
04/10/2024
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