Organization
LOOKOUT MOUNTAIN COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS FORD PHD (CEO)
(706) 638-5580
Entity
Organization
Contact information
Practice address
2106 GAIL ST, ROSSVILLE, GA 30741-3828
(706) 861-3353
Mailing address
PO BOX 1027, LA FAYETTE, GA 30728-1027
(706) 638-5580
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000604513D-31
—
GA
Enumeration date
03/01/2007
Last updated
07/21/2022
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