Individual ProviderKenneth Lawrence LandSocial WorkerBehavioral Health & Social Service ProvidersPractice Address342 S Ashley St, Ann Arbor, MI 48104-1351(734) 761-7204PECOS EnrollmentBased on the most recent information from CMS, provider Kenneth Lawrence Land 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 9:43 AM.Profile DetailsProvider ID1396825873Provider TypeIndividualFull NameLand, Kenneth LawrenceTitleMr.CredentialC.S.W.GenderMaleSole ProprietorYesEnumeration Date10/17/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address342 S Ashley St, Ann Arbor, MI 48104-1351Phone(734) 761-7204Fax(734) 761-7226Mailing LocationMailing Address342 S Ashley St, Ann Arbor, MI 48104-1351Phone(734) 761-7204Fax(734) 761-7226Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense6801017870Michigan