Individual ProviderNegatha KellyCase Manager/Care CoordinatorOther Service ProvidersPractice Address614 S Main St, Opelousas, LA 70570-6056(337) 381-0630PECOS EnrollmentBased on the most recent information from CMS, provider Negatha Kelly 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 4 days ago.Profile DetailsProvider ID1922555713Provider TypeIndividualFull NameKelly, NegathaGenderFemaleSole ProprietorNoEnumeration Date9/8/2016Last Updated2/28/2024Contact InformationPractice LocationPractice Address614 S Main St, Opelousas, LA 70570-6056Phone(337) 381-0630FaxUnlisted FaxMailing LocationMailing Address614 S Main St, Opelousas, LA 70570-6056Phone(337) 381-0630FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer