Aegis Treatment Centers, LLC
Organization Active NPI Methadone Clinic · Wilmington, CA
NPI 1457797201 · NPPES record last updated Aug 24, 2023
Key facts
- NPI
- 1457797201
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Methadone Clinic 261QM2800X
- Legal business name
- AEGIS TREATMENT CENTERS, LLC
- Practice address
- 909 N Avalon Blvd
Wilmington, CA 90744-4503 - Phone
- (310) 513-1300
- NPI assigned
- May 21, 2013
- Organization subpart
- No
Authorized official
- Name
- Denise Winant
- Title
- Credentialing Supervisor
- Phone
- (856) 439-6111
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Aegis Treatment Centers LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Methadone Clinic | 261QM2800X | CA | Yes |
Addresses
Primary practice location
909 N Avalon Blvd
Wilmington, CA 90744-4503
Mailing address
1317 Route 73 Ste 200
Mount Laurel, NJ 08054-2202
Phone (856) 439-6111
Other practice location 1
1322 N Avalon Blvd
Wilmington, CA 90744-2639
Phone (310) 513-1300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HDC70093F | Medicaid | CA |
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All providers in Wilmington, 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 Aug 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.