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Organization
ACT MENTAL HEALTH SERVICES, LLC
Active
Organization
ACT MENTAL HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JUNE ANN STALEY PMHNP-BC (PRESIDENT)
(855) 647-4228
Entity
Organization
Contact information
Practice address
30 ACOMA BLVD S, LAKE HAVASU CITY, AZ 86403-5957
(855) 647-4228
Mailing address
2924 PONY DR, LAKE HAVASU CITY, AZ 86406-8432
(507) 380-7218
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/20/2018
Last updated
08/20/2018
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