AEGIS TREATMENT CENTERS, LLC (NPI# 1134565740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134565740 |
| Entity Type | Organization |
| Organization Name | AEGIS TREATMENT CENTERS, LLC |
| Other Organization Name | DBA: HEALTHY CONNECTIONS |
| Practice Address |
955 W. Center Street Suites 12a, 12b & 14 Manteca CA 95337 |
| Mailing Address |
7246 Remmet Ave Canoga Park CA 91303-1531 |
| Practice Telephone | 2092399600 |
| Mailing Telephone | (818) 206-0360 |
| Mailing Fax Number | 8182060371 |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | MR. ALEXANDER DODD (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8182063060 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
39-14 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| dba: Healthy Connections | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 955 W. Center Street, Suties 12a & 14, Manteca, CA 953377300 | 2094630870 | 2094631803 |
| 955 W Center St # 12a12b14, Manteca, CA 953377300 | 2092399600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083224141 | Aegis Treatment Centers, LLC | Clinic/Center | 1450 Bessie Ave Ste B, Tracy, CA 95376-3456 | 2020-08-04 |
| 1326698887 | Aegis Treatment Centers, LLC | Clinic/Center | 2107, 2109 & 2113 1st St, Eureka, CA 95501-0840 | 2019-09-17 |
| 1548819550 | Aegis Treatment Centers, LLC | Clinic/Center | 1111 W Inyokern Rd Ste B, Ridgecrest, CA 93555-2370 | 2019-09-11 |
| 1760922207 | Aegis Treatment Centers, LLC | Clinic/Center | 1137 Hartnell Avenue, Suite E, 1141, 1145 & 1147 Hartnell Avenue, Redding, CA 96002-2113 | 2017-03-02 |
| 1649669979 | Aegis Treatment Centers, LLC | Clinic/Center | 541 S Ham Ln Ste A&b, Lodi, CA 95242-3530 | 2015-01-09 |
| 1851444376 | Aegis Treatment Centers, LLC | Clinic/Center | 1839 S. El Dorado Street, Stockton, CA 95206-2025 | 2007-01-19 |
| 1316003601 | Aegis Treatment Centers, LLC | Clinic/Center | 2321 Pontius Ave, Los Angeles, CA 90064-1809 | 2006-12-29 |
| 1972669257 | Aegis Treatment Centers, LLC | Clinic/Center | 1322 N Avalon Blvd, Wilmington, CA 90744-2639 | 2006-12-29 |
| 1104982495 | Aegis Treatment Centers, LLC | Clinic/Center | 1343 W Main St Ste A&b, 1349 W. Main Street, Merced, CA 95340-4438 | 2006-12-29 |
| 1861558413 | Aegis Treatment Centers, LLC | Clinic/Center | 1133 Coloma Way, Suite # A, B and C, Roseville, CA 95661-4480 | 2006-12-28 |
| Street Address |
955 W. CENTER STREET, SUITES 12A, 12B & 14 |
| City | MANTECA |
| State | CA |
| Zip Code | 95337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640485 | Shanitta D Hines | Counselor | Victor Community Support Services, 302 Cherry Lane, CA 95337 | 2020-08-19 |
| 1548658685 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 401 S Airport Way, Manteca, CA 95337 | 2014-12-23 |
| 1225430655 | Elizabeth Julia Ann Tyner | Hearing Instrument Specialist | 1079 Eucalyptus, Suite B, Manteca, CA 95337 | 2014-09-17 |
| 1053668947 | Roger Cabo Inciong | Physical Therapist | 3652 Rapallo Way, Manteca, CA 95337 | 2012-08-09 |
| 1295997757 | Costco Wholesale Corporation | Pharmacy | 2440 Daniels St, Manteca, CA 95337 | 2008-06-26 |
| 1255474235 | Carmen Catherine Nunes | Marriage & Family Therapist | 1771 Yosemite Ave., Manteca, CA 95337 | 2007-02-15 |
| 1063577062 | Kathy Laverne Barron | Counselor | 1789 W. Yosemite Ave., Sierra Building, 1st Floor, Manteca, CA 95337 | 2006-12-27 |
| 1891853149 | R. Ciccarelli, Dds., R. Joseph, Dds., M. El Farra, Dds., D. Saini, Dds | Dentist | 1507 W. Yosemite, Manteca, CA 95337 | 2006-12-05 |
| 1467528265 | Annie Mathew | Pharmacist | 1777 West Yosemite Ave, Manteca, CA 95337 | 2006-11-27 |
| 1649355173 | Mark Adrian Grecco | Dentist | 1511 West Yosemite Ave., Manteca, CA 95337 | 2006-10-25 |
| Find all providers in zip 95337 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.