Organization
EXALT THE LIGHT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. IMANI SADE' HINES LPC (CLINICIAN/CEO)
(470) 236-1746
Entity
Organization
Contact information
Practice address
5204 WESTCHESTER LANE, NE, ATLANTA, GA 30345
(470) 236-9050
Mailing address
1700 NORTHSIDE DRIVE NW SUITE A7 PMB 2480, ATLANTA, GA 30318
(470) 236-9050
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/23/2024
Last updated
02/23/2024
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