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
14240 IMPERIAL HWY, LA MIRADA, CA 90638-1940
(562) 946-1587
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
01
—
19-053
NTP NUMBER
CA
Enumeration date
05/20/2013
Last updated
05/20/2013
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