Individual ProviderBrooke HenryCase Manager/Care CoordinatorOther Service ProvidersPractice Address119 W Vine St, Opelousas, LA 70570-5153(337) 692-3392PECOS EnrollmentBased on the most recent information from CMS, provider Brooke Henry 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 yesterday at 10:02 AM.Profile DetailsProvider ID1114564689Provider TypeIndividualFull NameHenry, BrookeCredentialBSGenderFemaleSole ProprietorNoEnumeration Date12/4/2019Last Updated6/24/2020Contact InformationPractice LocationPractice Address119 W Vine St, Opelousas, LA 70570-5153Phone(337) 692-3392Fax(337) 284-3034Mailing LocationMailing Address119 W Vine St, Opelousas, LA 70570-5153Phone(337) 692-3392Fax(337) 284-3034Provider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerLouisianaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID00000000000DescriptionMedicaidIssuerUnlistedLouisiana