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Organization

LOOKOUT MOUNTAIN COMMUNITY SERVICE

Active
Other names
Elizabeth Kay Anderson
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TOM FORD PHD (CEO)
(706) 638-5580
Entity
Organization

Contact information

Practice address
9234 HIGHWAY 151, LA FAYETTE, GA 30728-5124
(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
08/30/2012
Last updated
08/30/2012
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