NPI age
12 years
Enumerated 2013-10-04
● Active Type 2 · Organization
Sacred Waters, Llc
Sacred Waters, Llc is 1 of 165 technician, other organizations in Georgia.
Primary specialty
Technician, Other
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Jefferson
Managing Directo
Last NPPES update
2013-10-04
Source: monthly bulk 2026-05
How this organization compares
Across 165 active technician, other providers in Georgia.
NPI age
12 years
↑ 10 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2013 → 2026
2013-10Enumerated in NPPES
2013
2026
Where they practice
Primary practice location
500 Lanier Ave W Ste 701
Fayetteville, GA 302147643
Mailing address
500 Lanier Ave W Ste 701
Fayetteville, GA 302147643
Authorized official
Kelly Jefferson
Managing Directo
📞 7704609122
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Kelly Jefferson Specialist NPI 1811254055
Specialties
-
Technician, Other PrimaryA collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Sacred Waters Wellness
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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