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Organization

MOUNTAIN COMPREHENSIVE CARE CENTER, INC.

Active
Parent organization
MOUNTAIN COMPREHENSIVE CARE CENTER, INC.
Other names
Homeplace Clinic Louisa
Organization subpart
Yes

Provider details

NPI number
Legal business name
MOUNTAIN COMPREHENSIVE CARE CENTER, INC.
Authorized official
ROXANN CORDIAL (CREDENTIALING)
(606) 886-8572
Entity
Organization

Contact information

Practice address
118 BLAIRS WAY, LOUISA, KY 41230-6389
(606) 638-9522
(606) 638-3548
Mailing address
104 S FRONT AVE, PRESTONSBURG, KY 41653-1614
(606) 886-8572

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
700264
KY

Other

Enumeration date
02/08/2018
Last updated
08/15/2024
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