NPIMap

Lookout Mountain Community Service

Organization Active NPI Community/Behavioral Health Agency · Woodstock, GA

NPI 1487984134 · NPPES record last updated Dec 31, 2009

Key facts

NPI
1487984134
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
LOOKOUT MOUNTAIN COMMUNITY SERVICE
Practice address
525 Tomahawk TRL
Woodstock, GA 30188-1741
Phone
(706) 638-5580
Fax
(706) 638-5445
NPI assigned
Dec 31, 2009
Organization subpart
No

Authorized official

Name
Dr. Tom Ford
Title
Ceo
Phone
(706) 638-5580

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

525 Tomahawk TRL
Woodstock, GA 30188-1741

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
000604513DKMedicaidGA

Other names

  • Successful Outcomes-Now Other name

Other providers in Woodstock, GA

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

Sources for this page

Verify at the official NPI Registry.