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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