Organization
LOOKOUT MOUNTAIN COMMUNITY SERVICES
Active
Other names
Marc Gibson
Organization subpart
No
Provider details
NPI number
Authorized official
TOM FORD PHD (CEO)
(706) 638-5580
Entity
Organization
Contact information
Practice address
377 WILDEWOOD TRL, CHICKAMAUGA, GA 30707-3490
(423) 304-2847
(706) 638-5445
Mailing address
PO BOX 1027, LA FAYETTE, GA 30728-1027
(423) 304-2847
(706) 638-5445
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/23/2013
Last updated
01/23/2013
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