Individual ProviderHeaven S FaisonCase Manager/Care CoordinatorOther Service ProvidersPractice Address44447 10th St W, Lancaster, CA 93534-3324(818) 996-1051PECOS EnrollmentBased on the most recent information from CMS, provider Heaven S Faison 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 ID1134833700Provider TypeIndividualFull NameFaison, Heaven SGenderFemaleSole ProprietorNoEnumeration Date1/9/2023Last Updated1/9/2023Contact InformationPractice LocationPractice Address44447 10th St W, Lancaster, CA 93534-3324Phone(818) 996-1051FaxUnlisted FaxMailing LocationMailing Address18646 Oxnard St, Tarzana, CA 91356-1411PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDF4573359DescriptionMedicaidIssuerUnlistedCalifornia