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General NPI Number Information
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NPI Number | 1023976727
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Entity Type | Organization
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Legal Business Name | LOOKOUT MOUNTAIN COMMUNITY SERVICE
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Dates
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Enumeration Date | 01/12/2026
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 717 W JAMES AVE
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City | ROSSVILLE
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State | GA
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Zip | 30741-2121
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Country | US
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Telephone | 706-638-5580
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Fax | 888-251-2128
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Provider Business Mailing Address
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Address Line | 804 EAST VILLANOW STREET
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City | LAFAYETTE
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State | GA
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Zip | 30728
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Country | US
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Telephone | 706-670-1085
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Fax | 888-251-2128
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | STEPHANIE GIBSON
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Credential |
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Telephone | 423-304-2847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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