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NPI Code Detail

MEDICARE: LOOKOUT MOUNTAIN COMMUNITY SERVICES

MEDICARE: LOOKOUT MOUNTAIN COMMUNITY SERVICES
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 AgencyGA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568599090
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOOKOUT MOUNTAIN COMMUNITY SERVICES
Provider Business Mailing Address
First Line : PO BOX 1027
Second Line :
City : LAFAYETTE
State : GA
Zip : 30728
Country : US
Telephone Number : 706-638-5580
Fax Number : 706-638-6855
Provider Business Practice Location Address
First Line : 700 CITY HALL DR
Second Line :
City : FT OGLETHORPE
State : GA
Zip : 30742-7802
Country : US
Telephone Number : 706-638-5580
Fax Number :
Authorized Official
Title or Position : BILLING AND AR MANAGER
Name : DEBORAH FARRIS
Credential :
Telephone Number : 706-638-5580
Provider Enumeration Date : 02/28/2007
Last Update Date : 07/21/2022

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1942495114 — MRS. ANNETTE STACY SMITH LPN
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Directions to “LOOKOUT MOUNTAIN COMMUNITY SERVICES ” 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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