Lookout Mountain Community Services

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

NPI 1891869020 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1891869020
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
LOOKOUT MOUNTAIN COMMUNITY SERVICES
Practice address
89 Highway 48
Summerville, GA 30747-1506
Phone
(706) 857-5465
Fax
(706) 857-0934
NPI assigned
Nov 20, 2006
Organization subpart
No

Authorized official

Name
Thomas W. Ford, PH.D.
Title
Executive Director
Phone
(706) 638-5584

Corporate family (same tax ID) 22

Organizations that report the same tax identification number in the National Provider Directory.

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

89 Highway 48
Summerville, GA 30747-1506

Mailing address

PO Box 1027
La Fayette, GA 30728-1027
Phone (706) 638-5584

Other identifiers

IdentifierTypeStateIssuer
00604513U-34MedicaidGA

Other providers in Summerville, GA

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

Sources for this page

Verify at the official NPI Registry.