AEGIS TREATMENT CENTER (NPI# 1619477239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619477239 |
Entity Type | Organization |
Organization Name | AEGIS TREATMENT CENTER |
Other Organization Name | HEALTHY CONNECTIONS, INC |
Practice Address |
1839 S El Dorado St Stockton CA 95206-2025 |
Practice Telephone | 2094630872 |
Practice Fax Number | 2094664446 |
Mailing Telephone | 2094630872 |
Mailing Fax Number | 2094664446 |
Enumeration Date | 2018-02-20 |
Last Update Date | 2018-02-20 |
Authorized Official Name | MR. DA HER (CLINIC MANAGER) |
Authorized Official Telephone | 2094630872 |
Authorized Official Credential | CCAPP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 324500000X | Substance Abuse Rehabilitation Facility | =========6 | CA | Residential Treatment Facilities |
Other Name | Type Code |
---|---|
Healthy Connections, Inc | Doing Business As Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | AEGIS TREATMENT CENTERS LLC | 7246 Remmet Ave, Canoga Park, CA 91303-1531 |
Street Address |
1839 S EL DORADO ST |
City | STOCKTON |
State | CA |
Zip Code | 95206-2025 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164429700 | Hutchison Pharmacies Inc | Pharmacy | 1839 S El Dorado St, Stockton, CA 95206-2025 | 2005-06-28 |
1073174710 | Maribel Flores Perez | Counselor | 1839 S El Dorado St, Stockton, CA 95206-2025 | 2019-06-24 |
1629634290 | Alexandra Lucila Vargas | Counselor | 1839 S El Dorado St, Stockton, CA 95206-2025 | 2019-05-19 |
1588129993 | Kent Franklin Jones | Counselor | 1839 S El Dorado St, Stockton, CA 95206-2025 | 2019-02-11 |
1023580206 | Rajbir Kaur Bainiwal | Counselor | 1839 S El Dorado St, Stockton, CA 95206-2025 | 2018-12-27 |
1912478801 | Frank Joseph Silva II | Counselor | 1839 S El Dorado St, Stockton, CA 95206-2025 | 2018-12-17 |
1740757160 | Tiffany Cole | Counselor | 1839 S El Dorado St, Stockton, CA 95206-2025 | 2018-10-24 |
1447748520 | Rochelle Ann Sison | Counselor | 1839 S El Dorado St, Stockton, CA 95206-2025 | 2018-04-25 |
1558886507 | Linda Nguyen | Counselor | 1839 S El Dorado St, Stockton, CA 95206-2025 | 2017-08-10 |
1447770599 | Michael Pham | Counselor | 1839 S El Dorado St, Stockton, CA 95206-2025 | 2017-06-20 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760001051 | Family Support Home Care LLC | Home Health | 1872 Gordon Verner Cir, Stockton, CA 95206 | 2020-04-16 |
1003477837 | Mohit Kumar Gosai | Counselor | 2419 Ophir Street, Stockton, CA 95206 | 2019-06-24 |
1609336882 | Monica Fuentes-rodriguez | Licensed Psychiatric Technician | 7000 N Michael Canlis Blv, Stockton, CA 95206 | 2019-03-22 |
1013431972 | Esmeralda Garcia | Behavior Technician | 4508 Janell Ln, Stockton, CA 95206 | 2017-08-01 |
1437672722 | Margie Belinda Nudo Aquino | Nurse Practitioner | 3518 Cape York Ct., Stockton, CA 95206 | 2017-07-19 |
1689125163 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 2428 Warlow Ln, Stockton, CA 95206 | 2016-10-19 |
1891175592 | Tracy Ford | Case Manager/Care Coordinator | 1839 S El Dorado Street, Stockton, CA 95206 | 2015-06-08 |
1477826212 | Derrick Hardy | Driver | 3819 Wild Rose Ln, Stockton, CA 95206 | 2012-02-09 |
1053533117 | Roman Robles | Acupuncturist | 10 E Martin Luther King Jr., Stockton, CA 95206 | 2007-05-02 |
1568686830 | Anka Behavioral Health, Inc. | Community/Behavioral Health | 1117 S Grant Street, Stockton, CA 95206 | 2007-04-11 |
Find all providers in zip 95206 |
Taxonomy Code | 324500000X |
Grouping | Residential Treatment Facilities |
Classification | Substance Abuse Rehabilitation Facility |
A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
Notes: [7/1/2003: modified title, modified definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386123719 | Alcohol & Drug Awareness Program | Substance Abuse Rehabilitation Facility | 1981 Cherokee Rd, Stockton, CA 95205-2720 | 2018-08-07 |
1811395288 | Pacific Center for Addiction Services Inc. | Substance Abuse Rehabilitation Facility | 808 N Center St, Stockton, CA 95202-1610 | 2014-12-16 |
1528335791 | Stockton Circle of Friends Adult Programs | Substance Abuse Rehabilitation Facility | 3120 E Anita St, Stockton, CA 95205-3905 | 2011-11-16 |
1588295265 | Regina Prado | Substance Abuse Rehabilitation Facility | 1212 N California St, Stockton, CA 95202-1552 | 2020-01-30 |
1225494776 | South Stockton Circle of Friends Adult Alcohol and Drug Treatment Fac. | Substance Abuse Rehabilitation Facility | 1484 Carpenter Rd, Stockton, CA 95206-3805 | 2016-01-13 |
1831354786 | Healthcare Services, Inc. | Substance Abuse Rehabilitation Facility | 1609 N Wilson Way, Stockton, CA 95205-3119 | 2008-07-21 |
1578736062 | El Dorado House | Substance Abuse Rehabilitation Facility | 1700 S El Dorado St, Stockton, CA 95206-2000 | 2008-04-07 |
1225241433 | Elan Senior Living | Substance Abuse Rehabilitation Facility | 4410 N Pershing Ave, Suite C-1, Stockton, CA 95207-6900 | 2007-05-07 |
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1801497359 | California Care Detox & Treatment | Substance Abuse Rehabilitation Facility | 25542 Dana Mesa Dr, San Juan Capistrano, CA 92675-4311 | 2020-11-02 |
1952900797 | A Sacred Path | Substance Abuse Rehabilitation Facility | 5671 Spanish Flat Rd, Garden Valley, CA 95633 | 2020-10-22 |
1467051672 | Spearhead Health Centers, LLC. | Substance Abuse Rehabilitation Facility | 11704 Wilshire Blvd Ste 226, Los Angeles, CA 90025-1504 | 2020-10-19 |
1073111613 | A Place To Heal | Substance Abuse Rehabilitation Facility | 14540 Hamlin St Ste H, Van Nuys, CA 91411-4153 | 2020-10-15 |
1871191569 | Old Oak Ranch Recovery Center | Substance Abuse Rehabilitation Facility | 19401 Susan Way, Sonora, CA 95370-9266 | 2020-10-14 |
1962009845 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 9952 Grandview Dr, La Mesa, CA 91941-6874 | 2020-10-05 |
1376140384 | Magic House Recovery Inc | Substance Abuse Rehabilitation Facility | 1001 S Mountvale Ct, Anaheim, CA 92808-2108 | 2020-10-02 |
1942807060 | New Perceptions North, LLC | Substance Abuse Rehabilitation Facility | 5084 N Fruit Ave Ste 105, Fresno, CA 93711-3000 | 2020-10-01 |
1346857679 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 3480 Hidden Trail Dr, Jamul, CA 91935-2104 | 2020-09-30 |
1992312227 | Apex Recovery, LLC | Substance Abuse Rehabilitation Facility | 2810 Camino Del Rio S Ste 106, San Diego, CA 92108-3819 | 2020-09-30 |
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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.