Individual ProviderKellie JacksonSocial WorkerBehavioral Health & Social Service ProvidersPractice Address204 S Highlander Way Ste 3, Howell, MI 48843-2073(517) 581-8249PECOS EnrollmentBased on the most recent information from CMS, provider Kellie Jackson 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 12:57 PM.Profile DetailsProvider ID1386399202Provider TypeIndividualFull NameJackson, KellieGenderFemaleSole ProprietorYesEnumeration Date2/18/2022Last Updated2/18/2022Contact InformationPractice LocationPractice Address204 S Highlander Way Ste 3, Howell, MI 48843-2073Phone(517) 581-8249FaxUnlisted FaxMailing LocationMailing Address204 S Highlander Way Ste 3, Howell, MI 48843-2073PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer