Aegis Treatment Centers, LLC
Organization Active NPI Methadone Clinic · Eureka, CA
NPI 1326698887 · NPPES record last updated Sep 17, 2023
Key facts
- NPI
- 1326698887
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Methadone Clinic 261QM2800X
- Legal business name
- AEGIS TREATMENT CENTERS, LLC
- Practice address
- 2107, 2109 & 2113 1St St
Eureka, CA 95501-0840 - Phone
- (800) 821-0775
- Fax
- (818) 206-0379
- NPI assigned
- Sep 17, 2019
- Organization subpart
- No
Authorized official
- Name
- Denise Winant
- Title
- Credentialing Supervisor
- Phone
- (732) 570-0268
Other NPIs on the same Medicare enrollment 35
Corporate family (same tax ID) 24
Practitioners 13
-
Libier Burgara, LVN
-
Phillip Andrew Loyd, SUDCC II
-
Jahmil Ali Rippy, SUDRC #18014
-
Marilynne Sue Walpole, CADC L CA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Opioid treatment program
- Medicare-enrolled since Jan 1, 2020
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Aegis Treatment Centers LLC
Locations
2107 1st St
Eureka, CA 95501
Phone (707) 273-6395
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Methadone Clinic | 261QM2800X | Yes |
Addresses
Primary practice location
2107, 2109 & 2113 1St St
Eureka, CA 95501-0840
Mailing address
1317 Route 73 Ste 200
Mount Laurel, NJ 08054-2202
Phone (856) 439-6111
Other providers in Eureka, CA
- Kimberlee Adams
- Adaptive Behavioral Services, LLC
- Adcs Women'S Residential
- Tolulope Adesanmi
- Godwin Adjekuko
- Natalia Affonso Ferreira
- Alan Michael Aglugub
- Julio Rey Agosto
- Stacey Helen Aguilar
- Ruby Aguirre
All providers in Eureka, CA · Methadone Clinic in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.