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
1137 HARTNELL AVENUE, SUITE D & E, 1129, 1133, 1135, 1141, 1145 & 1147 HARTNELL AVENUE, REDDING, CA 96002-2113
(530) 345-3491
(530) 345-0261
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
04-02MU1
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-02MU1
CALIFORNIA DEPARTMENT OF HEALTH CARE SERVICES - NTP LICENSE
CA
01
—
CA10,297
CSAT
CA
Enumeration date
03/02/2017
Last updated
09/17/2023
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