Individual ProviderShelley R HollandRecreation TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address730 E Beach Blvd # 5128, Long Beach, MS 39560-6259(228) 214-3319PECOS EnrollmentBased on the most recent information from CMS, provider Shelley R Holland 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 ID1669832747Provider TypeIndividualFull NameHolland, Shelley RTitleMs.CredentialCTRSGenderFemaleSole ProprietorNoEnumeration Date3/2/2016Last Updated3/2/2016Contact InformationPractice LocationPractice Address730 E Beach Blvd # 5128, Long Beach, MS 39560-6259Phone(228) 214-3319FaxUnlisted FaxMailing LocationMailing Address730 E Beach Blvd # 5128, Long Beach, MS 39560-6259Phone(228) 214-3319FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225800000XPrimaryDescriptionRecreation TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense66563Mississippi