Organization
MOUNTAIN COMPREHENSIVE CARE CENTER, INC.
Active
Other names
Homeplace Clinic for Children and Families
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANN CORDIAL (CREDENTIALING COORDINATOR)
(606) 886-8572
Entity
Organization
Contact information
Practice address
1330 S MAYO TRL STE 201, PIKEVILLE, KY 41501-2321
(606) 432-0123
(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
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
05/03/2021
Last updated
10/21/2022
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