Organization
ASPIRE365 CONNECTICUT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZACHARY JENSON (CEO)
(801) 556-1977
Entity
Organization
Contact information
Practice address
679 STATE ST, NEW HAVEN, CT 06511-6509
(385) 352-9696
Mailing address
9350 S 150 E STE 320, SANDY, UT 84070-2707
(385) 352-9696
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
Primary
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
Other
Enumeration date
08/16/2021
Last updated
10/14/2024
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