Organization
ALCOVE MARYLAND LLC
Active
Other names
Psych360
Organization subpart
No
Provider details
NPI number
Authorized official
ROCCO CONIGLIO (OWNER)
(330) 969-9019
Entity
Organization
Contact information
Practice address
5000 THAYER CTR STE C, OAKLAND, MD 21550-1139
(330) 536-3746
(330) 267-4250
Mailing address
3593 MEDINA RD # 181, MEDINA, OH 44256-8182
(330) 536-3746
(330) 267-4250
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/16/2019
Last updated
10/16/2019
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