| Reaching Back Enteprise Llc | |
|
14220 Old Halls Ferry Rd Suite 201 Florissant MO 63034-2400 | |
| (314) 489-9517 | |
| (314) 383-1564 |
| Full Name | Reaching Back Enteprise Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 14220 Old Halls Ferry Rd, Florissant, Missouri |
| Authorized Official Name and Position | Nicholas Anton Wren (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 3144899517 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reaching Back Enteprise Llc P.o. 211115 St. Louis MO 63121-9998 Ph: (314) 489-9517 | Reaching Back Enteprise Llc 14220 Old Halls Ferry Rd Suite 201 Florissant MO 63034-2400 Ph: (314) 489-9517 |
| NPI Number | 1811207996 |
|---|---|
| Provider Enumeration Date | 10/07/2010 |
| Last Update Date | 10/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811207996 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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