Healthcare Provider Details

I. General information

NPI: 1669394201
Provider Name (Legal Business Name): LOOKOUT MOUNTAIN COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HIDDEN OAKS DR
FLINTSTONE GA
30725-2736
US

IV. Provider business mailing address

PO BOX 1027
LA FAYETTE GA
30728-1027
US

V. Phone/Fax

Practice location:
  • Phone: 706-670-1085
  • Fax: 888-251-2128
Mailing address:
  • Phone: 706-670-1085
  • Fax: 888-251-2128

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE GIBSON
Title or Position: REVENUE CYCLE MANAGER
Credential:
Phone: 423-304-2847