NPIMap

Organization Active NPI

Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Santa Maria, CA
National Provider Identifier
1003972654
Registry record updated Sep 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
AEGIS TREATMENT CENTERS, LLC
Practice address
115 E Fesler St
Santa Maria, CA 93454-4404
Phone
(805) 922-6597
Fax
(805) 922-5978
NPI assigned
Dec 28, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Denise Winant
Title
Credentialing Supervisor
Phone
(732) 570-0268

Other NPIs on the same Medicare enrollment 35

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 35

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200125000215 CA Part B Supplier - Opioid Treatment Program (Otp) 2365732690 35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ontario, CA; Oxnard, CA; Pasadena, CA; Pomona, CA; Redding, CA; Redlands, CA; Roseville, CA; Santa Barbara, CA…

National Provider Directory

National Provider Directory
Tax ID family
Aegis Treatment Centers LLC78 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

115 E Fesler St
Santa Maria, CA 93454
Phone (805) 357-5195

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X Primary

Addresses

NPPES NPI Registry

Primary practice location

115 E Fesler St
Santa Maria, CA 93454-4404

Mailing address

1317 Route 73 Ste 200
Mount Laurel, NJ 08054-2202
Phone (856) 439-6111

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
HDC70078FMedicaidCA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 17, 2023.

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694908800000",
    "number": "1003972654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 ROUTE 73 STE 200",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542202",
            "telephone_number": "856-439-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E FESLER ST",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934544404",
            "telephone_number": "805-922-6597",
            "fax_number": "805-922-5978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS TREATMENT CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2023-09-17",
        "certification_date": "2023-09-17",
        "status": "A",
        "authorized_official_last_name": "WINANT",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "CREDENTIALING SUPERVISOR",
        "authorized_official_telephone_number": "732-570-0268"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HDC70078F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.