Caelea Renee Henderson | Anchorage, AK • PECOS Search

Caelea Renee Henderson

Behavior Technician

Behavioral Health & Social Service Providers

4000 San Ernesto Ave, Anchorage, AK 99508-2874

(907) 729-5020 (907) 841-6582

PECOS Enrollment

Based on the most recent information from CMS, provider Caelea Renee Henderson 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
1144957820
Provider Type
Individual
Full Name
Henderson, Caelea Renee
Title
Miss

Gender
Female
Sole Proprietor
No
Enumeration Date
8/3/2022
Last Updated
8/3/2022

Contact Information

Practice Location

4000 San Ernesto Ave, Anchorage, AK 99508-2874

Unlisted Fax

Mailing Location

10221 Jamestown Dr Apt 403, Anchorage, AK 99507-4440

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106S00000X Primary	Description Behavior Technician Behavioral Health & Social Service Providers	License Unlisted Issuer