Individual ProviderSusana T EllisCase Manager/Care CoordinatorOther Service ProvidersPractice Address44421 10th St W Ste A, Lancaster, CA 93534-3335(818) 654-39121818654391PECOS EnrollmentBased on the most recent information from CMS, provider Susana T 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 yesterday at 9:16 AM.Profile DetailsProvider ID1255088894Provider TypeIndividualFull NameEllis, Susana TGenderFemaleSole ProprietorNoEnumeration Date3/3/2022Last Updated3/3/2022Contact InformationPractice LocationPractice Address44421 10th St W Ste A, Lancaster, CA 93534-3335Phone(818) 654-3912Fax(818) 936-0114Mailing LocationMailing Address44421 10th St W Ste A, Lancaster, CA 93534-3335Phone1818654391Fax(818) 936-0114Provider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer