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Organization
OCTOBER ROAD, INC.
Active
Organization
OCTOBER ROAD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON HENDRICKS (CHIEF EXECUTIVE OFFICER)
(148) 940-0407
Entity
Organization
Contact information
Practice address
1304 PLAZA DR STE 2312, BURLINGTON, NC 27215-7165
(828) 350-1000
(828) 350-1300
Mailing address
119 TUNNEL RD STE D, ASHEVILLE, NC 28805-1800
(828) 350-1000
(828) 350-1300
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8305312
—
NC
Enumeration date
09/03/2020
Last updated
04/10/2024
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