Individual ProviderRaquell KelleyCase Manager/Care CoordinatorOther Service ProvidersPractice Address5577 Airport Hwy Ste 102, Toledo, OH 43615-7364(419) 214-1770PECOS EnrollmentBased on the most recent information from CMS, provider Raquell Kelley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1003527987Provider TypeIndividualFull NameKelley, RaquellGenderFemaleSole ProprietorYesEnumeration Date12/12/2022Last Updated12/12/2022Contact InformationPractice LocationPractice Address5577 Airport Hwy Ste 102, Toledo, OH 43615-7364Phone(419) 214-1770Fax(419) 214-0922Mailing LocationMailing Address5577 Airport Hwy Ste 102, Toledo, OH 43615-7364Phone(419) 214-1770Fax(419) 214-0922Provider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer