OCTOBER ROAD INC
NPI 1376389940
Community/Behavioral Health in Jacksonville, NC
- Organization
- Community/Behavioral Health
- Accepts Insurance
- CLIA Number: 34D2337946
- CLIA Cert. Type: Independent
- CLIA Exp. Date: 02-02-2028
About OCTOBER ROAD INC
This page provides the complete NPI Profile along with additional information for October Road Inc, a provider established in Jacksonville, North Carolina operating as a Community/behavioral Health. The healthcare provider is registered in the NPI registry with number 1376389940 assigned on July 2024. The practitioner's primary taxonomy code is 251S00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Jason Hendricks (Ceo)
- NPI
- 1376389940 Verify this NPI
- Provider Name
- OCTOBER ROAD INC
- Entity Type
- Organization
- Location Address
- 255 WILLIAMSBURG PKWY JACKSONVILLE, NC 28546
- Location Phone
- (828) 606-9013
- Mailing Address
- PO BOX 967 DUNCANSVILLE, PA 16635
- Mailing Phone
- (814) 940-0407
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-03-2024
- Last Update Date
- 04-04-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Community/Behavioral Health
- Taxonomy Code
- 251S00000X
- Type
- Agencies
- Taxonomy Description
- A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Complete | $60 PCP | $20 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Bronze HSA Eligible | Integrated | Nationwide Doctors - PPO
- Blue Advantage Bronze Standard | Nationwide Doctors - PPO
- Blue Advantage Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Gold Standard A | Nationwide Doctors - PPO
- Blue Advantage Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Nationwide Doctors - PPO
- Blue Advantage Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Nationwide Doctors - PPO
- Blue Advantage Silver Standard | Nationwide Doctors - PPO
- Blue Care Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | Statewide Doctors - HMO
- Blue Care Bronze Complete | $60 PCP | $20 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Bronze HSA Eligible | Integrated | Statewide Doctors - HMO
- Blue Care Bronze Standard | Statewide Doctors - HMO
- Blue Care Gold Premier A | 3 Free PCP | $10 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Gold Standard A | Statewide Doctors - HMO
- Blue Care Silver Choice A | 3 Free PCP | $15 Tier 1 Rx | Statewide Doctors - HMO
- Blue Care Silver Preferred | 3 Free PCP | $10 Tier 1 Rx | Integrated | Statewide Doctors - HMO
- Blue Care Silver Standard | Statewide Doctors - HMO
- Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with Novant Health - EPO
- Blue Home Bronze Basic | 3 Free PCP | $25 Tier 1 Rx | Integrated | with UNC Health Alliance - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 34D2337946
- Facility Type
- Independent
- Certificate Effective Date
- February 03, 2026
- Certificate Expiration Date
- February 02, 2028
- Laboratory Director
- ALLEN GLIPIN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to October Road Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1376389940, enumerated as an "organization" on July 03, 2024.
The provider is located at 255 WILLIAMSBURG PKWY JACKSONVILLE, NC 28546 and the phone number is (828) 606-9013.
Community/Behavioral Health with taxonomy code 251S00000X.
The provider might be accepting Accepts: Blue Cross and Blue Shield of NC. Please consult your insurance carrier or call the provider to verify.
