Individual ProviderKassandra LuceroCase Manager/Care CoordinatorOther Service ProvidersPractice Address4118 Central Ave SE, Albuquerque, NM 87108-1177(505) 554-3057PECOS EnrollmentBased on the most recent information from CMS, provider Kassandra Lucero 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 ID1629632930Provider TypeIndividualFull NameLucero, KassandraGenderFemaleSole ProprietorNoEnumeration Date4/23/2019Last Updated4/23/2019Contact InformationPractice LocationPractice Address4118 Central Ave SE, Albuquerque, NM 87108-1177Phone(505) 554-3057FaxUnlisted FaxMailing LocationMailing AddressPO Box 35014, Albuquerque, NM 87176-5014Phone(505) 554-3057FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer