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NPI Code Detail

MEDICARE: ASPIRE365 NEW JERSEY LLC

MEDICARE: ASPIRE365 NEW JERSEY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2103TA0400XAddiction (Substance Use Disorder) Psychologist
3163WA0400XAddiction (Substance Use Disorder) Registered Nurse
42084A0401XAddiction Medicine (Psychiatry & Neurology) Physician
52083A0300XAddiction Medicine (Preventive Medicine) Physician

General Provider Information

NPI Number : 1346958196
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASPIRE365 NEW JERSEY LLC
Provider Business Mailing Address
First Line : 9350 S 150 E STE 320
Second Line :
City : SANDY
State : UT
Zip : 84070-2707
Country : US
Telephone Number : 385-352-9696
Fax Number : 385-287-1035
Provider Business Practice Location Address
First Line : 300 CARNEGIE CTR STE 150
Second Line :
City : PRINCETON
State : NJ
Zip : 08540-6285
Country : US
Telephone Number : 385-352-9696
Fax Number : 385-287-1035
Authorized Official
Title or Position : CEO
Name : ZACH JENSON
Credential :
Telephone Number : 385-352-9746
Provider Enumeration Date : 11/10/2022
Last Update Date : 10/14/2024

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Directions to “ASPIRE365 NEW JERSEY LLC ” Practice Location

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