Individual ProviderCassie DavisSocial WorkerBehavioral Health & Social Service ProvidersPractice Address3522 Briar Creek Ln, Ammon, ID 83406-4728(208) 529-1660PECOS EnrollmentBased on the most recent information from CMS, provider Cassie Davis 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 2 days ago.Profile DetailsProvider ID1720320328Provider TypeIndividualFull NameDavis, CassieGenderFemaleSole ProprietorYesEnumeration Date3/21/2013Last Updated3/21/2013Contact InformationPractice LocationPractice Address3522 Briar Creek Ln, Ammon, ID 83406-4728Phone(208) 529-1660Fax(208) 529-1699Mailing LocationMailing Address3522 Briar Creek Ln, Po Box 3858, Ammon, ID 83406-4728Phone(208) 529-1660Fax(208) 529-1699Provider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseLMSW-32584IdahoProvider IdentifiersIDDescriptionIssuerIDLMSW-32584DescriptionOtherIssuerSTATE LICENSE - LMSWIdaho