Organization
LOOKOUT MOUNTAIN COMMUNITY SERVICE
Active
Other names
DD Behavioral Support Now
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM FORD PHD (CEO)
(706) 638-5580
Entity
Organization
Contact information
Practice address
1427 LEE CLARKSON RD, CHICKAMAUGA, GA 30707-3344
(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
Enumeration date
04/17/2012
Last updated
04/17/2012
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