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NPI Code Detail

MEDICARE: LOOKOUT MOUNTAIN COMMUNITY SERVICE

MEDICARE: LOOKOUT MOUNTAIN COMMUNITY SERVICE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1184962326
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOOKOUT MOUNTAIN COMMUNITY SERVICE
Provider Business Mailing Address
First Line : PO BOX 1027
Second Line :
City : LA FAYETTE
State : GA
Zip : 30728-1027
Country : US
Telephone Number : 423-304-2847
Fax Number : 706-638-5445
Provider Business Practice Location Address
First Line : 1929 VILLANOW MILL CREEK RD
Second Line :
City : LA FAYETTE
State : GA
Zip : 30728-5732
Country : US
Telephone Number : 706-638-5580
Fax Number : 706-638-5445
Authorized Official
Title or Position : CREDENTIALING
Name : ALICIA MICHELLE HOWARD
Credential :
Telephone Number : 706-670-1080
Provider Enumeration Date : 01/23/2013
Last Update Date : 02/10/2023

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Directions to “LOOKOUT MOUNTAIN COMMUNITY SERVICE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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