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
1133 COLOMA WAY, SUITE # A, B AND C, ROSEVILLE, CA 95661-4480
(916) 774-6647
(916) 774-6456
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
—
HDC70085F
—
CA
Enumeration date
12/28/2006
Last updated
09/17/2023
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