Organization
LOOKOUT MOUNTAIN COMMUNITY SERVICE
Active
Organization
LOOKOUT MOUNTAIN COMMUNITY SERVICE
Active
Other names
Amber Cruise
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM FORD PHD (CEO)
(706) 638-5584
Entity
Organization
Contact information
Practice address
284 WORTHINGTON GAP RD, ROCK SPRING, GA 30739-2278
(706) 638-5580
(706) 638-5445
Mailing address
PO BOX 1027, LA FAYETTE, GA 30728-1027
(706) 638-5580
(706) 638-5545
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/29/2013
Last updated
10/29/2013
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