Organization
REACHING BACK ENTEPRISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS ANTON WREN LPC (LICENSED PROFESSIONAL COUNSELOR)
(314) 489-9517
Entity
Organization
Contact information
Practice address
14220 OLD HALLS FERRY RD, SUITE 201, FLORISSANT, MO 63034-2400
(314) 489-9517
(314) 383-1564
Mailing address
P.O. 211115, ST. LOUIS, MO 63121-9998
(314) 489-9517
(314) 383-1564
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/07/2010
Last updated
10/07/2010
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