| Organization Name: | OCTOBER ROAD, INC. |
| NPI Number: | 1851574503 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHAD HUSTED (DIRECTOR OF NC OPERATIONS) |
| Mailing Address: | 885 Crossroads Pkwy A2 Mars Hill |
| State: | NC US |
| Postal Code: | 287549244 |
| Phone Number: | 8283501000 |
| Fax Number: | 8286893997 |
| NPI Enumeration Date: | 12/17/2007 |
| NPI Last Update Date: | 04/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | MHL-057-021 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |