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Lookout Mountain Community Services

Organization Active NPI Community/Behavioral Health Agency · La Fayette, GA

NPI 1104064609 · NPPES record last updated Feb 10, 2023

Key facts

NPI
1104064609
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
LOOKOUT MOUNTAIN COMMUNITY SERVICES
Practice address
2448 Corinth Rd
La Fayette, GA 30728-3869
Phone
(706) 638-5580
Fax
(706) 638-5585
NPI assigned
Jan 22, 2009
Organization subpart
No

Authorized official

Name
Alicia Michelle Howard
Title
Credentialing
Phone
(706) 670-1080

Corporate family (same tax ID) 21

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Lookout Mountain Community Services (107 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Yes

Addresses

Primary practice location

2448 Corinth Rd
La Fayette, GA 30728-3869

Mailing address

PO Box 1027
La Fayette, GA 30728-1027
Phone (706) 638-5580

Other identifiers

IdentifierTypeStateIssuer
000604513CZMedicaidGA

Other providers in La Fayette, GA

All providers in La Fayette, GA · Community/Behavioral Health Agency in Georgia

Sources for this page

Verify at the official NPI Registry.