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LOOKOUT MOUNTAIN COMMUNITY SERVICE NPI 1124343132


NPI Information

NPI: 1124343132
Provider Name: LOOKOUT MOUNTAIN COMMUNITY SERVICE

Doing Business As: MARCUS LOGAN

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
168 OAK HILL DR
LA FAYETTE, GA
ZIP 30728
Phone: (706) 638-5580
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LOOKOUT MOUNTAIN COMMUNITY SERVICE is a community behavioral health in La Fayette, GA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. LOOKOUT MOUNTAIN COMMUNITY SERVICE NPI is 1124343132. The provider is registered as an organization entity type.
The provider Is Doing Business As Marcus Logan.

The provider's business location address is:

168 OAK HILL DR
LA FAYETTE, GA
ZIP 30728-284
Phone: (706) 638-5580
Fax: (706) 638-5445

The provider's authorized official is Alicia Michelle Howard .
The authorized official title is Credentialing and has the following contact phone number (706) 670-1080.

The enumeration date for this NPI number is 4/1/2010 and was last updated on 2/10/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1000604513DCMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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