Alcove Maryland LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

ALCOVE MARYLAND LLC

Doing business as

Psych360

Practice address

5000 Thayer Ctr Ste C
Oakland, MD 21550-1139

Phone

(330) 536-3746

Fax

(330) 267-4250

NPI assigned

Oct 16, 2019

Last updated

Oct 16, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Rocco Coniglio

Title

Owner

Phone

(330) 969-9019

Specialties & licenses 2

Addresses

Other names 1

• Psych360 Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571184000000",
    "number": "1437791977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3593 MEDINA RD # 181",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442568182",
            "telephone_number": "330-536-3746",
            "fax_number": "330-267-4250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 THAYER CTR STE C",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501139",
            "telephone_number": "330-536-3746",
            "fax_number": "330-267-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALCOVE MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A",
        "authorized_official_last_name": "CONIGLIO",
        "authorized_official_first_name": "ROCCO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-969-9019"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psych360",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychiatric/Mental Health Nurse Practitioner in Oakland, MD
• Providers in Oakland, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.