Organization
ASPIRE365 GEORGIA LLC
Active
Organization
ASPIRE365 GEORGIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZACHARY JENSON (CEO)
(385) 352-9746
Entity
Organization
Contact information
Practice address
3379 PEACHTREE RD NE STE 655, ATLANTA, GA 30326-1535
(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
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
10/14/2024
Last updated
10/28/2024
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