Organization
AEGIS TREATMENT CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXANDER CHARLES DODD (EXECUTIVE DIRECTOR)
(415) 205-9005
Entity
Organization
Contact information
Practice address
6500 MORRO RD STE D, ATASCADERO, CA 93422-4142
(805) 461-5212
Mailing address
6500 MORRO RD STE D, ATASCADERO, CA 93422-4142
(805) 461-5212
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
40-01
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4003
—
CA
Enumeration date
05/20/2013
Last updated
05/20/2013
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