Eliza Chantle Moses | Roxbury, MA • PECOS Search

Eliza Chantle Moses

Counselor

Behavioral Health & Social Service Providers

520 Dudley St, Roxbury, MA 02119-2769

(617) 989-9499 (857) 200-7211

PECOS Enrollment

Based on the most recent information from CMS, provider Eliza Chantle Moses does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1063767432
Provider Type
Individual
Full Name
Moses, Eliza Chantle
Title
Ms.

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/20/2012
Last Updated
7/20/2012

Contact Information

Practice Location

520 Dudley St, Roxbury, MA 02119-2769

Unlisted Fax

Mailing Location

289 Pine Grove Dr, Brockton, MA 02301-1122

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101Y00000X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer