Individual ProviderLuis Rafael CruzCounselorBehavioral Health & Social Service ProvidersPractice Address504 Dudley St, Roxbury, MA 02119-2732(786) 348-4412PECOS EnrollmentBased on the most recent information from CMS, provider Luis Rafael Cruz 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 12:57 PM.Profile DetailsProvider ID1104607233Provider TypeIndividualFull NameCruz, Luis RafaelGenderMaleSole ProprietorYesEnumeration Date10/13/2023Last Updated10/13/2023Contact InformationPractice LocationPractice Address504 Dudley St, Roxbury, MA 02119-2732Phone(786) 348-4412FaxUnlisted FaxMailing LocationMailing Address504 Dudley St, Roxbury, MA 02119-2732PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer