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NPI Code Detail

MEDICARE: ONE ALKALINE LIFE LLC

MEDICARE: ONE ALKALINE LIFE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1801777313
Entity Type Code : Organization
Provider Name (Legal Business Name) : ONE ALKALINE LIFE LLC
Provider Business Mailing Address
First Line : 1036 SAINT NICHOLAS DR UNIT 102
Second Line :
City : WALDORF
State : MD
Zip : 20603-4758
Country : US
Telephone Number : 410-934-0580
Fax Number : 410-834-1217
Provider Business Practice Location Address
First Line : 1036 SAINT NICHOLAS DR UNIT 102
Second Line :
City : WALDORF
State : MD
Zip : 20603-4758
Country : US
Telephone Number : 410-934-0580
Fax Number : 410-834-1217
Authorized Official
Title or Position : BILLING DIRECTOR
Name : KAREN S WEIR
Credential :
Telephone Number : 864-691-6244
Provider Enumeration Date : 09/10/2025
Last Update Date : 04/10/2026

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Directions to “ONE ALKALINE LIFE LLC ” Practice Location

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