Aspire365 Connecticut

Organization Active NPI Addiction Medicine (Preventive Medicine) Physician · New Haven, CT

NPI 1053086587 · NPPES record last updated Oct 14, 2024

Key facts

NPI
1053086587
Entity type
Organization (NPI type 2)
Primary specialty
Addiction Medicine (Preventive Medicine) Physician 2083A0300X
Legal business name
ASPIRE365 CONNECTICUT
Practice address
679 State St
New Haven, CT 06511-6509
Phone
(385) 352-9696
NPI assigned
Aug 16, 2021
Organization subpart
No

Authorized official

Name
Mr. Zachary Jenson
Title
Ceo
Phone
(801) 556-1977

National Provider Directory

Locations

679 State St
New Haven, CT 06511

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YA0400X
Addiction (Substance Use Disorder) Psychologist
Group: 193200000X MULTI-SPECIALTY GROUP
103TA0400X
Addiction (Substance Use Disorder) Registered Nurse
Group: 193200000X MULTI-SPECIALTY GROUP
163WA0400X
Addiction Medicine (Preventive Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2083A0300X Yes
Addiction Medicine (Psychiatry & Neurology) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2084A0401X

Addresses

Primary practice location

679 State St
New Haven, CT 06511-6509

Mailing address

9350 S 150 E Ste 320
Sandy, UT 84070-2707
Phone (385) 352-9696

Other providers in New Haven, CT

All providers in New Haven, CT · Addiction Medicine (Preventive Medicine) Physician in Connecticut

Sources for this page

Verify at the official NPI Registry.