Healthcare Provider Details

I. General information

NPI: 1568380723
Provider Name (Legal Business Name): ALIMENTA COLLECTIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3114 ELLERSLIE AVE
BALTIMORE MD
21218-3516
US

IV. Provider business mailing address

3114 ELLERSLIE AVE
BALTIMORE MD
21218-3516
US

V. Phone/Fax

Practice location:
  • Phone: 443-405-2896
  • Fax:
Mailing address:
  • Phone: 443-405-2896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: BRIANNA LAEL EANANI BRENNAN
Title or Position: NUTRITIONIST
Credential: CNS
Phone: 443-405-2896