| October Road, Inc. | |
|
1304 Plaza Dr Ste 2312 Burlington NC 27215-7165 | |
| (828) 350-1000 | |
| (828) 350-1300 |
| Full Name | October Road, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1304 Plaza Dr Ste 2312, Burlington, North Carolina |
| Authorized Official Name and Position | Jason Hendricks (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 1489400407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| October Road, Inc. 119 Tunnel Rd Ste D Asheville NC 28805-1800 Ph: (828) 350-1000 | October Road, Inc. 1304 Plaza Dr Ste 2312 Burlington NC 27215-7165 Ph: (828) 350-1000 |
| NPI Number | 1669086948 |
|---|---|
| Provider Enumeration Date | 09/03/2020 |
| Last Update Date | 04/10/2024 |
| Certification Date | 04/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669086948 | NPI | - | NPPES |
| 8305312 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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