# SWEETWATER COLLECTIVE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SWEETWATER COLLECTIVE LLC
- **Other names:** Fayette Acupuncture & Integrative Medicine
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1578139218
- **Legal business name:** SWEETWATER COLLECTIVE LLC
- **Authorized official:** BARBARA JOIE V JACALA LAC AEMP (CEO)
- **Authorized official phone:** (678) 310-3182

## Contact information

- **Practice address:** 101 DEVANT ST STE 1001, FAYETTEVILLE, GA 30214-2719
- **Practice address phone:** (678) 310-3182
- **Practice address fax:** (678) 788-6690
- **Mailing address:** 101 DEVANT ST STE 1001, FAYETTEVILLE, GA 30214-2719
- **Mailing address phone:** (678) 310-3182
- **Mailing address fax:** (678) 788-6690

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | — | — | Yes |

## Other

- **Enumeration date:** 06/02/2021
- **Last updated:** 02/08/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 521 | ACUPUNCTURIST | GA |