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Lookout Mountain Community Service

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

NPI 1831429588 · NPPES record last updated Dec 31, 2009

Key facts

NPI
1831429588
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
LOOKOUT MOUNTAIN COMMUNITY SERVICE
Practice address
12580 N Main St
Suite B
Trenton, GA 30752-2227
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)

Locations

12580 N Main St
Ste B
Trenton, GA 30752

Specialties & licenses

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

Addresses

Primary practice location

12580 N Main St
Suite B
Trenton, GA 30752-2227

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
000604513DEMedicaidGA

Other names

  • Ancor West-Now Other name

Other providers in Trenton, GA

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

Sources for this page

Verify at the official NPI Registry.