Provider Demographics
NPI:1477171403
Name:INREACH
Entity type:Organization
Organization Name:INREACH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MRS
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 1:4014 MONROE RD STE 170
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-0094
Mailing Address - Country:US
Mailing Address - Phone:704-536-6661
Mailing Address - Fax:704-536-0074
Practice Address - Street 1:2021 CAMDEN RD
Practice Address - Street 2:
Practice Address - City:WINGATE
Practice Address - State:NC
Practice Address - Zip Code:28174-8796
Practice Address - Country:US
Practice Address - Phone:704-536-6661
Practice Address - Fax:704-536-0074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-07
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No251S00000XAgenciesCommunity/Behavioral Health