Organization
MOUNTAIN COMPREHENSIVE CARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROMOD BISHNOI (EXECUTIVE DIRECTOR)
(606) 886-8572
Entity
Organization
Contact information
Practice address
104 S FRONT AVE, PRESTONSBURG, KY 41653-1614
(606) 886-8572
(606) 886-4433
Mailing address
104 S FRONT AVE, PRESTONSBURG, KY 41653-1614
(606) 886-8572
(606) 886-4433
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
10/02/2008
Last updated
12/04/2008
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