Healthcare Provider Details

I. General information

NPI: 1669214920
Provider Name (Legal Business Name): A HEALTHIER DEMOCRACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2024
Last Update Date: 06/08/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 MOHAWK ST UNIT 9
BOSTON MA
02127-3594
US

IV. Provider business mailing address

3112 HOLMES AVE S
MINNEAPOLIS MN
55408-2629
US

V. Phone/Fax

Practice location:
  • Phone: 848-218-0009
  • Fax:
Mailing address:
  • Phone: 857-205-5849
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN RUXIN
Title or Position: CHIEF OPERATING OFFICER
Credential: MBA
Phone: 857-205-5849