Individual ProviderCrystal CageCounselorBehavioral Health & Social Service ProvidersPractice Address1644 Carter St Ste 2, Vidalia, LA 71373-3143(318) 414-3065PECOS EnrollmentBased on the most recent information from CMS, provider Crystal Cage 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 9:54 AM.Profile DetailsProvider ID1982153821Provider TypeIndividualFull NameCage, CrystalGenderFemaleSole ProprietorNoEnumeration Date10/3/2016Last Updated10/3/2016Contact InformationPractice LocationPractice Address1644 Carter St Ste 2, Vidalia, LA 71373-3143Phone(318) 414-3065Fax(318) 414-3067Mailing LocationMailing Address1644 Carter St Ste 2, Vidalia, LA 71373-3143Phone(318) 414-3065Fax(318) 414-3067Provider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer