Organization
INREACH
Active
Other names
Camden Road Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI GOUGEON (PRESIDENT CEO)
(704) 536-6661
Entity
Organization
Contact information
Practice address
2021 CAMDEN RD, WINGATE, NC 28174-8796
(704) 536-6661
(704) 536-0074
Mailing address
4014 MONROE RD STE 170, CHARLOTTE, NC 28205-0094
(704) 536-6661
(704) 536-0074
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/07/2020
Last updated
03/17/2025
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