Individual ProviderKellie HenryCase Manager/Care CoordinatorOther Service ProvidersPractice Address115 S Main St Ste A, Opelousas, LA 70570-6133(225) 938-1360PECOS EnrollmentBased on the most recent information from CMS, provider Kellie Henry 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 3 days ago.Profile DetailsProvider ID1588204671Provider TypeIndividualFull NameHenry, KellieGenderFemaleSole ProprietorYesEnumeration Date1/7/2020Last Updated2/18/2020Contact InformationPractice LocationPractice Address115 S Main St Ste A, Opelousas, LA 70570-6133Phone(225) 938-1360FaxUnlisted FaxMailing LocationMailing Address115 S Main St Ste A, Opelousas, LA 70570-6133Phone(225) 938-1360Fax(337) 407-5104Provider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer