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General NPI Number Information
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NPI Number | 1770271470
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Entity Type | Organization
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Legal Business Name | ANCHOR BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 65-1206 MAMALAHOA HWY BUILDING 2 OFFICE 3
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City | KAMUELA
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State | HI
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Zip | 96743
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Country | US
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Telephone | 808-731-9006
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Fax |
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Provider Business Mailing Address
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Address Line | 65-1206 MAMALAHOA HWY BUILDING 2 OFFICE 3
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City | KAMUELA
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State | HI
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Zip | 96743
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Country | US
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Telephone | 808-731-9006
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGIE NICOLE STANLEY
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Credential | NP
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Telephone | 808-731-9006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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