Mountain Comprehensive Care Center, Inc.
Organization Active NPI Federally Qualified Health Center (FQHC) · Inez, KY
NPI 1992505663 · NPPES record last updated Mar 13, 2025
Key facts
- NPI
- 1992505663
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- Legal business name
- MOUNTAIN COMPREHENSIVE CARE CENTER, INC.
- Practice address
- 154 Rockcastle Rd
Inez, KY 41224 - Phone
- (606) 298-7902
- NPI assigned
- Mar 13, 2025
- Organization subpart
- No
Authorized official
- Name
- Roxann Cordial
- Title
- Credentialing Manager
- Phone
- (606) 886-8572
Other NPIs on the same Medicare enrollment 24
Other NPIs with the same Medicare PAC ID 24
Corporate family (same tax ID) 43
Practitioners 89
-
Sheila Adkins, NP
-
Melissa Aguilar, APRN
-
Brooke Leemae Bays, APRN
-
Imani Blunt, LCSW
-
Kyndra Boone, PMHNP
-
Kristin J Bowman, APRN
-
Karen Bradley, APRN
-
Jessica Lee Branham, D.O.
-
Jessica Briggs, LCSW
-
James Adam Butler, LPCC
-
Angela M Campbell, APRN
-
Deonna Campbell, APRN-PMHNP
-
Jessica Campbell, APRN
-
Sarah J Campbell, APRN
-
Carla J Castle, APRN-FNP
-
Robert Darrell Castle II, LCADC/LPCC
-
Sarah Coleman, LCSW
-
Keisha Combs, LCSW
-
Carolyn Compton, APRN
-
Martha E. Copley Coleman, LCSW
-
Ashley Cornett, APRN, PMHNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in KY
Federally qualified health center certification: CCN B01175
- Legal name
- MOUNTAIN COMPREHENSIVE CARE CENTER INC
- Doing business as
- HOMEPLACE BEHAVIORAL HEALTH - INEZ
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Apr 29, 2025
- Last certification
- Apr 29, 2025
- Ownership / control type
- For profit – corporation
- Organization structure
- Corporation · Non-profit
- Enrollment address
- 154 Rockcastle Rd
Inez, KY 41224
All disclosed owners & managing parties 9
| Name | Role | Since | Share |
|---|---|---|---|
| Lynette Schindler |
Corporate Director |
Jan 1, 2017 | |
| Jackie Tackett |
Corporate Director |
Jan 1, 2017 | |
| Durward E Hale |
Corporate Director |
Jan 1, 2017 | |
| Charles Branham |
Corporate Director |
Jan 1, 2019 | |
| Paula Thompson |
Corporate Director |
Jan 1, 2014 | |
| Teresa Petot |
Corporate Director |
Jan 1, 2017 | |
| Shirley Ratcliff |
Corporate Director |
Jan 1, 2015 | |
| Amanda Looney |
W-2 Managing Employee |
Dec 6, 2025 | |
| Promod Bishnoi |
Corporate Director |
Jul 31, 2008 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040416000380 | KY | Part B Supplier - Clinic/Group Practice | 5294720553 |
Receives reassigned benefits from 237 practitioners 24 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Paintsville, KY; Pikeville, KY; Prestonsburg, KY; Salyersville, KY; Winchester, KY; Martin, KY; Ashland, KY; Belfry, KY… |
| O20250429002773 | KY | Part a Provider - Federally Qualified Health Center (FQHC) | 5294720553 | Practice locations: Inez, KY |
National Provider Directory
- Tax ID family
- Mountain Comprehensive Ca
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | Yes |
Addresses
Primary practice location
154 Rockcastle Rd
Inez, KY 41224
Mailing address
104 S Front Ave
Prestonsburg, KY 41653-1614
Phone (606) 886-8572
Other names
- Homeplace Behavioral Health - Inez
Other providers in Inez, KY
- Stacye Elizabeth McQueen
- Megan Mellert
- Bethany Mills
- Johnny Mills
- Mountain Comprehensive Care Center, Inc.
- Sharon N Neeley
- Net Care Inc
- Loretta Kay Nichols
- Lauren Niece
- Ohio Valley Physicians Inc
All providers in Inez, KY · Federally Qualified Health Center (FQHC) in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.