Organization
BOSTON RUIZ
Active
Parent organization
SNEAKAHEADZ LLC
Other names
Boston Ruiz
Organization subpart
Yes
Provider details
NPI number
Legal business name
SNEAKAHEADZ LLC
Authorized official
BOSTON RUIZ CPE, CCHW (OWNER)
(480) 898-6459
Entity
Organization
Contact information
Practice address
719 E PEPPER PL, MESA, AZ 85203-8747
(480) 798-6459
Mailing address
719 E PEPPER PL, MESA, AZ 85203-8747
(480) 798-6459
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
106S00000X
Behavior Technician
—
—
133NN1002X
Nutrition Education Nutritionist
—
—
171400000X
Health & Wellness Coach
—
—
171M00000X
Case Manager/Care Coordinator
—
—
171W00000X
Contractor
—
—
172V00000X
Community Health Worker
Primary
—
—
174H00000X
Health Educator
—
—
175T00000X
Peer Specialist
—
—
251300000X
Local Education Agency (LEA)
—
—
251B00000X
Case Management Agency
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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