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General NPI Number Information
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NPI Number | 1598625360
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Entity Type | Organization
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Legal Business Name | AEGIS TREATMENT CENTERS, LLC
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Dates
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Enumeration Date | 11/14/2025
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 501 S MAIN ST
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City | YREKA
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State | CA
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Zip | 96097-3024
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Country | US
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Telephone | 530-222-7213
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Fax | 530-222-7268
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Provider Business Mailing Address
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Address Line | 1317 ROUTE 73 STE 200
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City | MOUNT LAUREL
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State | NJ
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Zip | 08054-2202
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Country | US
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Telephone | 856-439-6111
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Fax | 856-581-8147
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Authorized Official
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Title or Position | CREDENTIALING SUPERVISOR
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Name | DENISE WINANT
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Credential |
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Telephone | 732-570-0268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM2800X
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Taxonomy Name | Methadone Clinic
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License Number |
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License Number State |
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