| October Road Actt 4 | |
|
3080 Sunset Ave Rocky Mount NC 27804-3647 | |
| (828) 606-9013 | |
| Not Available |
| Full Name | October Road Actt 4 |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3080 Sunset Ave, Rocky Mount, North Carolina |
| Authorized Official Name and Position | Jason Hendricks (CEO) |
| Authorized Official Contact | 8149400407 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| October Road Actt 4 119 Tunnel Rd Ste D Asheville NC 28805-1800 Ph: (828) 350-1000 | October Road Actt 4 3080 Sunset Ave Rocky Mount NC 27804-3647 Ph: (828) 606-9013 |
| NPI Number | 1801670385 |
|---|---|
| Provider Enumeration Date | 08/24/2023 |
| Last Update Date | 04/10/2024 |
| Certification Date | 04/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801670385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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