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Lookout Mountain Community Services

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

NPI 1669923322 · NPPES record last updated Oct 18, 2016

Key facts

NPI
1669923322
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
LOOKOUT MOUNTAIN COMMUNITY SERVICES
Practice address
73 Sherry CT
Chickamauga, GA 30707-1887
Phone
(706) 638-5580
Fax
(706) 639-2054
NPI assigned
Oct 18, 2016
Organization subpart
No

Authorized official

Name
Dr. Tom Ford, PHD
Title
Ceo
Phone
(706) 638-5584

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

73 Sherry CT
Chickamauga, GA 30707-1887

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
000810059OMedicaidGA

Other names

  • Rhonda Whitaker Doing business as

Other providers in Chickamauga, GA

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

Sources for this page

Verify at the official NPI Registry.