Provider Demographics
NPI:1346761822
Name:INREACH
Entity Type:Organization
Organization Name:INREACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:GOUGEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-536-6661
Mailing Address - Street 1:4530 PARK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-3790
Mailing Address - Country:US
Mailing Address - Phone:704-536-6661
Mailing Address - Fax:704-536-0074
Practice Address - Street 1:146 WINCHESTER AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-3161
Practice Address - Country:US
Practice Address - Phone:704-536-6661
Practice Address - Fax:704-296-9639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-05
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health