Organization
MOUNTAIN COMPREHENSIVE CARE CENTER, INC.
Active
Other names
Homeplace Clinic Hazard IOP
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANN CORDIAL (CREDENTIALING MANAGER)
(606) 886-8572
Entity
Organization
Contact information
Practice address
1565 COMBS RD, HAZARD, KY 41701-6579
(606) 910-0309
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
—
—
Other
Enumeration date
06/04/2025
Last updated
06/04/2025
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