Individual ProviderChanelle EllisCase Manager/Care CoordinatorOther Service ProvidersPractice Address44421 10th St W, Lancaster, CA 93534-3335(818) 654-3912PECOS EnrollmentBased on the most recent information from CMS, provider Chanelle Ellis 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 2 days ago.Profile DetailsProvider ID1013488238Provider TypeIndividualFull NameEllis, ChanelleGenderFemaleSole ProprietorNoEnumeration Date12/16/2018Last Updated2/13/2023Contact InformationPractice LocationPractice Address44421 10th St W, Lancaster, CA 93534-3335Phone(818) 654-3912Fax(818) 241-6853Mailing LocationMailing Address44421 10th St W, Lancaster, CA 93534-3335Phone(818) 654-3912Fax(818) 241-6853Provider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerCode106S00000XDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer