Provider Demographics
NPI:1467901116
Name:ASPIRE ADDICTION RECOVERY CENTERS
Entity Type:Organization
Organization Name:ASPIRE ADDICTION RECOVERY CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-973-7400
Mailing Address - Street 1:1144 W 3300 S # 200
Mailing Address - Street 2:
Mailing Address - City:SOUTH SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84119-3330
Mailing Address - Country:US
Mailing Address - Phone:801-973-7400
Mailing Address - Fax:888-855-1472
Practice Address - Street 1:1144 W 3300 S # 200
Practice Address - Street 2:
Practice Address - City:SOUTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84119-3330
Practice Address - Country:US
Practice Address - Phone:801-973-7400
Practice Address - Fax:888-855-1472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT28971324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility