Organization
LOOKOUT MOUNTAIN COMMUNITY SERVICE
Active
Organization
LOOKOUT MOUNTAIN COMMUNITY SERVICE
Active
Other names
Cassandra Waters
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS FORD PHD. (CEO)
(706) 638-5580
Entity
Organization
Contact information
Practice address
1531 HIGHWAY 95, ROCK SPRING, GA 30739-2398
(706) 638-5580
(706) 638-5445
Mailing address
PO BOX 1027, LA FAYETTE, GA 30728-1027
(706) 638-5580
(706) 638-5445
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000604513CS
—
GA
Enumeration date
03/31/2010
Last updated
03/31/2010
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