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Lookout Mountain Community Service

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

NPI 1194047225 · NPPES record last updated Feb 10, 2023

Key facts

NPI
1194047225
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
LOOKOUT MOUNTAIN COMMUNITY SERVICE
Practice address
501 Mize St
La Fayette, GA 30728-3346
Phone
(706) 638-5580
Fax
(706) 638-5445
NPI assigned
Feb 16, 2010
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 24

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

501 Mize St
La Fayette, GA 30728-3346

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
000604513DNMedicaidGA

Other names

  • Kaye Horne-Host Home Doing business as

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.