Provider Demographics
NPI:1184236721
Name:JONES, OCTOBER (CNA)
Entity type:Individual
Prefix:MISS
First Name:OCTOBER
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1870
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-5870
Mailing Address - Country:US
Mailing Address - Phone:205-239-8852
Mailing Address - Fax:
Practice Address - Street 1:HANDS OVER HEARTS LLC
Practice Address - Street 2:1025 23RD STREET SOUTH -387
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205
Practice Address - Country:US
Practice Address - Phone:205-239-8852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-17
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities