# 360TEAM PSYCHIATRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780267146
- **Authorized official:** JOE VAP (GENERAL MANAGER)
- **Authorized official phone:** (502) 244-2420

## Contact information

- **Practice address:** 740 COMMERCE DR STE A, PERRYSBURG, OH 43551-5276
- **Practice address phone:** (502) 244-2420
- **Practice address fax:** (502) 996-8282
- **Mailing address:** 12910 SHELBYVILLE RD STE 300, LOUISVILLE, KY 40243-2404
- **Mailing address phone:** (502) 244-2420
- **Mailing address fax:** (502) 996-8282

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/04/2021
- **Last updated:** 05/04/2021