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Organization
OCTOBER ROAD INC
Active
Organization
OCTOBER ROAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON HENDRICKS (CEO)
(814) 940-0407
Entity
Organization
Contact information
Practice address
255 WILLIAMSBURG PKWY, JACKSONVILLE, NC 28546-6856
(828) 606-9013
Mailing address
PO BOX 967, DUNCANSVILLE, PA 16635-0967
(814) 940-0407
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
Other
Enumeration date
07/03/2024
Last updated
04/04/2025
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