Organization
ASPIRE365 SOUTH CAROLINA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZACHARY JENSON (CEO)
(385) 352-9696
Entity
Organization
Contact information
Practice address
141 TRACTION ST, GREENVILLE, SC 29611-4725
(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
101YM0800X
Mental Health Counselor
—
—
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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