Individual ProviderMary Alice JacksonCase Manager/Care CoordinatorOther Service ProvidersPractice Address2325 Cerrillos Rd, Santa Fe, NM 87505-3373(505) 438-0010PECOS EnrollmentBased on the most recent information from CMS, provider Mary Alice Jackson 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 9:43 AM.Profile DetailsProvider ID1508144965Provider TypeIndividualFull NameJackson, Mary AliceGenderFemaleSole ProprietorYesEnumeration Date8/2/2011Last Updated8/2/2011Contact InformationPractice LocationPractice Address2325 Cerrillos Rd, Santa Fe, NM 87505-3373Phone(505) 438-0010Fax(505) 438-6011Mailing LocationMailing Address2325 Cerrillos Rd, Santa Fe, NM 87505-3373Phone(505) 438-0010Fax(505) 438-6011Provider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer