AEGIS TREATMENT CENTERS, LLC (NPI# 1851444376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851444376 |
| Entity Type | Organization |
| Organization Name | AEGIS TREATMENT CENTERS, LLC |
| Other Organization Name | DBA: HEALTHY CONNECTIONS, DBA:5TH STREET MEDICAL CLINIC |
| Practice Address |
1839 S. El Dorado Street Stockton CA 95206-2025 |
| Mailing Address |
7246 Remmet Ave Canoga Park CA 91303-1531 |
| Practice Telephone | 2094630870 |
| Practice Fax Number | 2094630560 |
| Mailing Telephone | 8182060360 |
| Mailing Fax Number | 8182060360 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2016-11-01 |
| Authorized Official Name | ALEXANDER DODD (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 8182060360 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
39-12 | CA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| dba: Healthy Connections, dba:5th Street Medical Clinic | Doing Business As Name - Organization |
| 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 |
| 1134565740 | Aegis Treatment Centers, LLC | Clinic/Center | 955 W. Center Street, Suites 12a, 12b & 14, Manteca, CA 95337 | 2013-05-22 |
| 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 |
1839 S. EL DORADO STREET |
| City | STOCKTON |
| State | CA |
| Zip Code | 95206-2025 |
| 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 | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164082277 | Elizabeth Perez | Clinic/Center | 1982 S Drake Ave, Stockton, CA 95215-7449 | 2019-06-20 |
| 1558554915 | Pacific Valley Recovery Center Incorporated | Clinic/Center | 820 E Main St, Stockton, CA 95202-3129 | 2007-08-20 |
| 1710030325 | Aegis Treatment Centers, LLC | Clinic/Center | 1947 N California St, Suite B and C, Stockton, CA 95204-6029 | 2007-01-18 |
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| 1003427337 | Restorative Partners, Inc. | Clinic/Center | 3220 S Higuera St Ste 103a, San Luis Obispo, CA 93401-2023 | 2020-08-11 |
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| 1104435734 | New Life Health Authority / Dba New Life LLC | Clinic/Center | 280 E Standley St, Ukiah, CA 95482-4414 | 2020-07-29 |
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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.