Individual ProviderLaquisha KelleyCase Manager/Care CoordinatorOther Service ProvidersPractice Address211 South Jackson Street, Camden, AR 71701(870) 836-5743PECOS EnrollmentBased on the most recent information from CMS, provider Laquisha Kelley 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 6 days ago.Profile DetailsProvider ID1609236454Provider TypeIndividualFull NameKelley, LaquishaGenderFemaleSole ProprietorNoEnumeration Date3/7/2016Last Updated3/7/2016Contact InformationPractice LocationPractice Address211 South Jackson Street, Camden, AR 71701Phone(870) 836-5743FaxUnlisted FaxMailing LocationMailing Address211 Jackson St SW, Camden, AR 71701-3941Phone(870) 836-5743FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer