Organization
LOOKOUT MOUNTAIN COMMUNITY SERVCIE
Active
Other names
JAMIE SMITH
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOM FORD PHD (CEO)
(706) 638-5580
Entity
Organization
Contact information
Practice address
3341 LAKE HOWARD RD, LA FAYETTE, GA 30728-6251
(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
08/01/2012
Last updated
08/01/2012
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