Organization
AEGIS TREATMENT CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER CHARLES DODD (EXECUTIVE DIRECTOR)
(415) 205-9005
Entity
Organization
Contact information
Practice address
8626 LOWER SACRAMENTO RD, SUITE #41, STOCKTON, CA 95210-1835
(209) 478-2487
Mailing address
7246 REMMET AVE, CANOGA PARK, CA 91303-1531
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HDC70090F
—
CA
Enumeration date
05/21/2013
Last updated
05/21/2013
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