Provider Demographics
NPI:1801762661
Name:INREACH
Entity type:Organization
Organization Name:INREACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
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 1:648 BLOOMOVER ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-9055
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:2025-10-16
Last Update Date:2025-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCMHL-013-265Medicaid