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SWEETWATER LIFE LLC NPI 1790201044


NPI Information

NPI: 1790201044
Provider Name: SWEETWATER LIFE, LLC
Classification: Massage Therapist - 225700000X
Entity Type: Organization
Address:
1117 MCGILL PARK AVE NE
ATLANTA, GA
ZIP 30312
Phone: (404) 734-8853
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SWEETWATER LIFE, LLC is a massage therapist in Atlanta, GA. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. SWEETWATER LIFE, LLC NPI is 1790201044. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1117 MCGILL PARK AVE NE
ATLANTA, GA
ZIP 30312-221
Phone: (404) 734-8853

The provider's authorized official is Lekeisha Marquis Jones .
The authorized official title is Owner and has the following contact phone number (404) 734-8853.

The enumeration date for this NPI number is 8/18/2017 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1173C00000XReflexologistMT008978GEORGIANo
2390200000XStudent in an Organized Health Care Education/Training ProgramGEORGIANo
3225700000XMassage TherapistMT008978GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1MT008978OTHERGEORGIAMASSAGE THERAPY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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