Organization
AEGIS TREATMENT CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE WINANT (CREDENTIALING SUPERVISOR)
(732) 570-0268
Entity
Organization
Contact information
Practice address
8626 LOWER SACRAMENTO RD STE 41, SUITE 41, STOCKTON, CA 95210-1835
(209) 478-2487
(209) 478-1476
Mailing address
1317 ROUTE 73 STE 200, MOUNT LAUREL, NJ 08054-2202
(856) 439-6111
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HDC70090F
—
CA
Enumeration date
12/28/2006
Last updated
09/17/2023
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