Active NPI
Mountain Comprehensive Care Center, Inc.
Doing business as Homeplace Clinic West Liberty
- Federally Qualified Health Center (FQHC)
- West Liberty, KY
National Provider Identifier
1619880036
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- MOUNTAIN COMPREHENSIVE CARE CENTER, INC.
- Doing business as
- Homeplace Clinic West Liberty
- Practice address
- 1749 W Main St
West Liberty, KY 41472-9773 - Phone
- (606) 886-8572
- NPI assigned
- Sep 25, 2026
- Last updated
- Sep 25, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Roxann Cordial
- Title
- Credentialing Manager
- Phone
- (606) 886-8572
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Primary |
Addresses
Primary practice location
1749 W Main St
West Liberty, KY 41472-9773
Mailing address
104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572
Other names 1
- Homeplace Clinic West Liberty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790294400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1790294400000",
"number": "1619880036",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 S FRONT AVE",
"city": "PRESTONSBURG",
"state": "KY",
"postal_code": "416531614",
"telephone_number": "606-886-8572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1749 W MAIN ST",
"city": "WEST LIBERTY",
"state": "KY",
"postal_code": "414729773",
"telephone_number": "606-886-8572"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MOUNTAIN COMPREHENSIVE CARE CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-25",
"last_updated": "2026-09-25",
"certification_date": "2026-09-25",
"status": "A",
"authorized_official_last_name": "CORDIAL",
"authorized_official_first_name": "ROXANN",
"authorized_official_title_or_position": "CREDENTIALING MANAGER",
"authorized_official_telephone_number": "606-886-8572"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Homeplace Clinic West Liberty",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in West Liberty, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.