Lookout Mountain Community Services
Organization Active NPI Community/Behavioral Health Agency · La Fayette, GA
NPI 1467526749 · NPPES record last updated Feb 10, 2023
Key facts
- NPI
- 1467526749
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- LOOKOUT MOUNTAIN COMMUNITY SERVICES
- Practice address
- 806 E Villanow St
La Fayette, GA 30728-2609 - Phone
- (706) 639-2108
- Fax
- (706) 639-2114
- NPI assigned
- Nov 20, 2006
- Organization subpart
- No
Authorized official
- Name
- Alicia Michelle Howard
- Title
- Credentialing
- Phone
- (706) 670-1080
Corporate family (same tax ID) 24
Practitioners 1
-
Bonnie Lynn Rose, RN
National Provider Directory
- Tax ID family
- Lookout Mountain Community Services
Locations
806 E Villanow St
La Fayette, GA 30728
Phone (706) 639-2108
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
806 E Villanow St
La Fayette, GA 30728-2609
Mailing address
PO Box 1027
La Fayette, GA 30728-1027
Phone (706) 638-5584
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00604513G-41 | Medicaid | GA |
Other providers in La Fayette, GA
- Lookout Mountain Community Services
- Lookout Mountain Community Services
- Lookout Mountain Community Services
- Lookout Mountain Community Services
- Lookout Mountain Community Services
- Lookout Mountain Community Services
- Lookout Mountain Community Services
- Lookout Mountain Community Services
- Lookout Mountain Community Services
- Lookout Mountain Community Services
All providers in La Fayette, GA · Community/Behavioral Health Agency in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.