AEGIS TREATMENT CENTERS, LLC - NPI 1376293407 - Clinic/Center in Banning, CA

Q: What is the provider's specialty?

The provider's specialty is Clinic/Center with taxonomy code 261QM2800X and a focus in Methadone.

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About Aegis Treatment Centers, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AEGIS TREATMENT CENTERS, LLC (NPI 1376293407) is a healthcare organization registered as a methadone in Banning, California and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through March 29, 2027 and lists Denise Winant, Credentialing Supervisor, as its authorized official.

NPPES Registry Identity

NPI1376293407

Entity TypeOrganization

Primary Taxonomy261QM2800X

Legal Business NameAEGIS TREATMENT CENTERS, LLC

Location Address2781 W RAMSEY ST STE 3&4Banning, CA 92220-3700

Mailing Address1317 Route 73 Ste 200Mount Laurel, NJ 08054-2202 · (856) 439-1111

Phone(800) 821-0775

Fax(818) 206-0381

Organization SubpartNo

Authorized OfficialDenise WinantCredentialing Supervisor · (732) 570-0268

Enumeration DateMarch 23, 2022

Last NPPES UpdateSeptember 20, 2023

NPPES CertifiedSeptember 20, 2023

✔ NPI 1376293407 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities

Taxonomy Code261QM2800X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

2781 W RAMSEY ST STE 3&4, Banning, CA 92220

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2279215

Aegis Treatment Centers LLC · Banning, CA

Active · expires Mar 29, 2027

CLIA Number05D2279215

Laboratory TypeNarcotic Treatment

Certificate Effective DateMarch 30, 2025

Certificate Expiration DateMarch 29, 2027

Laboratory DirectorBarry N. Solof

Laboratory Phone(951) 417-6612

Laboratory LocationAegis Treatment Centers LLC2781 W Ramsey St, Ste 4, Banning, CA 92220

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. JENNIFER JANE HAYNES-CASEY LVN

Licensed Vocational Nurse