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NPI Code Detail

MEDICARE: ASPIRE365 VIRGINIA

MEDICARE: ASPIRE365 VIRGINIA
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 : 1477226470
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASPIRE365 VIRGINIA
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 :
Provider Business Practice Location Address
First Line : 4860 COX RD STE 200
Second Line :
City : GLEN ALLEN
State : VA
Zip : 23060-9248
Country : US
Telephone Number : 804-935-8551
Fax Number :
Authorized Official
Title or Position : MANAGING MEMBER
Name : MR. ZACHARY JENSON
Credential :
Telephone Number : 801-556-1977
Provider Enumeration Date : 07/27/2021
Last Update Date : 10/14/2024

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Directions to “ASPIRE365 VIRGINIA ” Practice Location

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