Organization
INREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI A GOUGEON (PRESIDENT)
(704) 536-6661
Entity
Organization
Contact information
Practice address
4014 MONROE RD STE 170, CHARLOTTE, NC 28205-0094
(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
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
311ZA0620X
Adult Care Home Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3408799
—
NC
Enumeration date
09/21/2006
Last updated
03/17/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up