Provider Demographics
NPI:1588479174
Name:ALKALINE ELEVATION LLC
Entity type:Organization
Organization Name:ALKALINE ELEVATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF WELLNESS
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-925-2027
Mailing Address - Street 1:20 NORTHLODGE CT
Mailing Address - Street 2:
Mailing Address - City:WENDELL
Mailing Address - State:NC
Mailing Address - Zip Code:27591-9831
Mailing Address - Country:US
Mailing Address - Phone:919-901-9562
Mailing Address - Fax:
Practice Address - Street 1:20 NORTHLODGE CT
Practice Address - Street 2:
Practice Address - City:WENDELL
Practice Address - State:NC
Practice Address - Zip Code:27591-9831
Practice Address - Country:US
Practice Address - Phone:407-925-2027
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management