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
1501 ZION CHURCH RD E, CONCORD, NC 28025-6827
(724) 996-2744
Mailing address
PO BOX 967, DUNCANSVILLE, PA 16635-0967
(814) 940-0407
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/30/2024
Last updated
01/21/2026
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