| Exalt The Light, Llc | |
|
5204 Westchester Lane, Ne Atlanta GA 30345 | |
| (470) 236-9050 | |
| Not Available |
| Full Name | Exalt The Light, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5204 Westchester Lane, Ne, Atlanta, Georgia |
| Authorized Official Name and Position | Imani Sade' Hines (CLINICIAN/CEO) |
| Authorized Official Contact | 4702361746 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Exalt The Light, Llc 1700 Northside Drive Nw Suite A7 Pmb 2480 Atlanta GA 30318 Ph: (470) 236-9050 | Exalt The Light, Llc 5204 Westchester Lane, Ne Atlanta GA 30345 Ph: (470) 236-9050 |
| NPI Number | 1124884531 |
|---|---|
| Provider Enumeration Date | 02/23/2024 |
| Last Update Date | 02/23/2024 |
| Certification Date | 02/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124884531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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