Organization Active NPI

Lookout Mountain Community Service

Doing business as Amber Cruise

  • Community/Behavioral Health Agency
  • Rock Spring, GA
National Provider Identifier
1780012880
Registry record updated Oct 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
LOOKOUT MOUNTAIN COMMUNITY SERVICE
Doing business as
Amber Cruise
Practice address
284 Worthington Gap Rd
Rock Spring, GA 30739-2278
Phone
(706) 638-5580
Fax
(706) 638-5445
NPI assigned
Oct 29, 2013
Last updated
Oct 29, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

284 Worthington Gap Rd
Rock Spring, GA 30739-2278

Mailing address

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

Other names 1

  • Amber Cruise Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Lookout Mountain Community Services107 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383004800000",
    "number": "1780012880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1027",
            "city": "LA FAYETTE",
            "state": "GA",
            "postal_code": "307281027",
            "telephone_number": "706-638-5580",
            "fax_number": "706-638-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 WORTHINGTON GAP RD",
            "city": "ROCK SPRING",
            "state": "GA",
            "postal_code": "307392278",
            "telephone_number": "706-638-5580",
            "fax_number": "706-638-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOOKOUT MOUNTAIN COMMUNITY SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-29",
        "last_updated": "2013-10-29",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-638-5584",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amber Cruise",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rock Spring, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.