Organization · NPI-2

Aspire365 New York LLC

Preventive Medicine, Addiction Medicine · New York, NY

NPI number1154039196

StatusActive

Last updated in NPPESOct 14, 2024

Details

NPI: 1154039196
Entity type: Organization (NPI-2)
Legal business name: Aspire365 New York LLC
Organization subpart: No
Enumeration date: Nov 8, 2022
Certification date: Oct 14, 2024
Last updated: Oct 14, 2024

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
2083A0300X	Preventive Medicine, Addiction Medicine	–	–	Yes
101YA0400X	Counselor, Addiction (Substance Use Disorder)	–	–
103TA0400X	Psychologist, Addiction (Substance Use Disorder)	–	–
163WA0400X	Registered Nurse, Addiction (Substance Use Disorder)	–	–
2084A0401X	Psychiatry & Neurology, Addiction Medicine	–	–

Practice location

26 Broadway Ste 934-C54
New York, NY 10004-1703

Phone 385-352-9696 · Fax 385-287-1035

Mailing address

9350 S 150 E Ste 320
Sandy, UT 84070-2707

Phone 385-352-9696 · Fax 385-287-1035

Authorized official

Zach Jenson
Ceo
3853529746

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