NPIMap

Organization Active NPI

Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Inglewood, CA
National Provider Identifier
1679919419
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
AEGIS TREATMENT CENTERS, LLC
Practice address
614 W Manchester Blvd
#104
Inglewood, CA 90301-1656
Phone
(310) 412-0879
NPI assigned
May 20, 2013
Last updated
Mar 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X CA Primary

Addresses

Primary practice location

614 W Manchester Blvd
#104
Inglewood, CA 90301-1656

Mailing address

7246 Remmet Ave
Canoga Park, CA 91303-1531

Other identifiers 1

IdentifierTypeStateIssuer
HDC70073FMedicaidCA

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 24

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

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678665600000",
    "number": "1679919419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7246 REMMET AVE",
            "city": "CANOGA PARK",
            "state": "CA",
            "postal_code": "913031531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 W MANCHESTER BLVD",
            "address_2": "#104",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011656",
            "telephone_number": "310-412-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS TREATMENT CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-20",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "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": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "HDC70073F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inglewood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.