NPIMap

Organization Active NPI

Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Grass Valley, CA
National Provider Identifier
1871007534
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
109 Margaret LN
Grass Valley, CA 95945-5211
Phone
(530) 863-8798
Fax
(530) 477-7035
NPI assigned
Nov 16, 2017
Last updated
Sep 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 17, 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

109 Margaret LN
Grass Valley, CA 95945-5211

Mailing address

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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2138928Aegis Treatment Centers, LLC109 Margaret Lane, Grass Valley, CA 95945Certificate of waiverOct 25, 2027

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 20

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

View all 20

Locations

109 Margaret Ln
Grass Valley, CA 95945
Phone (530) 272-1931

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1510790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694908800000",
    "number": "1871007534",
    "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": "109 MARGARET LN",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455211",
            "telephone_number": "530-863-8798",
            "fax_number": "530-477-7035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AEGIS TREATMENT CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-16",
        "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": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, 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 Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.