Organization
LOOKOUT MOUNTAIN COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA MICHELLE HOWARD (CREDENTIALING)
(706) 670-1080
Entity
Organization
Contact information
Practice address
207 MILLSAP RD, LA FAYETTE, GA 30728-6339
(706) 638-5580
(706) 638-5585
Mailing address
PO BOX 1027, LA FAYETTE, GA 30728-1027
(706) 638-5580
(706) 638-5585
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000604513DB
—
GA
Enumeration date
01/29/2009
Last updated
02/10/2023
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