Centrell Self | Hammond, LA • PECOS Search

Centrell Self

Case Manager/Care Coordinator

Other Service Providers

1417 W Morris Ave Ste E, Hammond, LA 70403-3854

PECOS Enrollment

Based on the most recent information from CMS, provider Centrell Self 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 8 days ago.

Profile Details

Provider ID
1356874887
Provider Type
Individual
Full Name
Self, Centrell
Gender
Female

Sole Proprietor
Yes
Enumeration Date
4/11/2017
Last Updated
5/16/2019

Contact Information

Practice Location

1417 W Morris Ave Ste E, Hammond, LA 70403-3854

Unlisted Fax

Mailing Location

90 Highway 1045, Amite, LA 70422-7264

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171M00000X Primary	Description Case Manager/Care Coordinator Other Service Providers	License 14439 Louisiana