Provider Demographics
NPI:1619861473
Name:ONELIFE WELLNESS LLC
Entity type:Organization
Organization Name:ONELIFE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACKWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-231-0938
Mailing Address - Street 1:PO BOX 28576
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-0159
Mailing Address - Country:US
Mailing Address - Phone:480-231-0938
Mailing Address - Fax:
Practice Address - Street 1:17838 E BEAR WALLOW WAY
Practice Address - Street 2:
Practice Address - City:RIO VERDE
Practice Address - State:AZ
Practice Address - Zip Code:85263-5376
Practice Address - Country:US
Practice Address - Phone:480-269-4069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251F00000XAgenciesHome Infusion